Radiological Changes in the Chest in Malignant Trophoblastic Disease

Abstract

Summary18 of 22 patients with malignant trophoblastic disease had radiological evidence of intrathoracic metastases. Of these 18 patients, 10 presented with pulmonary symptoms, 1 with cerebral symptoms, 1 with pulmonary and cerebral symptoms. 3 patients were asymptomatic and were discovered to have pulmonary metastases on the chest radiograph in the course of follow‐up for recent molar pregnancy. Only three patients presented with gynaecological symptoms.The findings on the chest radiograph included discrete intrapulmonary nodules in 15 patients, pleural elfusions in 2 patients, a hilar mass in 1 patient, confiuent opacities in 1 patient and miliary mottling in 1 patient.Other radiological features reported in the literature are those of pulmonary hypertension, pulmonary infarction, paramediastinal mass and pulmonary calcification.In view of the success of chemotherapy in some of these advanced cases, the possibility of trophoblastic malignancy should be borne in mind whenever these radiological appearances are encountered in young female patients, especially those presenting with haemoptysis or cerebral symptoms, even in the absence of overt pelvic disease.