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01.12.2014 | Case report | Ausgabe 1/2014 Open Access

Journal of Medical Case Reports 1/2014

Haemoptysis from a pulmonary arteriovenous malformation in a post molar pregnancy gestational trophoblast tumour patient managed by radiological embolisation: a case report

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2014
Autoren:
Zoë McDonald-Burrows, Rhian Davies, Elizabeth Goode, Candice Clarke, James Jackson, Michael Seckl, Philip Savage
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-8-117) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

All the authors have read and approved the final version of this manuscript. RD, EG, CC and PS were involved in writing the manuscript. RD and ZMB compiled the final draft of the manuscript. PS revised the manuscript critically and was a major contributor in writing the manuscript. JJ provided the radiological input for the case and prepared the images. EG, CC, JJ, MS and PS were involved in the clinical care of the patient. PS is the corresponding author.

Abstract

Introduction

Gestational trophoblastic tumours are a rare form of malignancy, which in the majority of cases arise from abnormal trophoblast cells formed in a complete molar pregnancy. These tumours are extremely sensitive to chemotherapy and high cure rates approaching 100% can be expected. The disease is usually limited to the uterus where the abnormal trophoblast proliferation and human chorionic production can lead to vascular changes including the formation of arteriovenous malformations.

Case presentation

We describe the case of a 28-year-old Caucasian woman who presented to the United Kingdom's Gestational Trophoblast Tumour Service with rising human chorionic gonadotropin levels following a uterine evacuation for a complete molar pregnancy. She was commenced on chemotherapy but subsequently reported two episodes of haemoptysis. Computed tomography imaging demonstrated findings consistent with a pulmonary arteriovenous malformation, probably due to a small pulmonary metastasis, complicated by recent haemorrhage. These findings were confirmed on emergency pulmonary arteriography, and the pulmonary arteriovenous malformation was successfully embolised.

Conclusions

Arteriovenous malformations secondary to gestational trophoblastic tumours at metastatic sites have only been reported in a very limited number of cases. When significant bleeding occurs, as in this case of a pulmonary lesion, urgent referral for embolisation is indicated.

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Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Authors’ original file for figure 4
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Authors’ original file for figure 5
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