An unusual case of primary pulmonary choriocarcinoma with brain metastasis in a HIV positive patient

Abstract

Primary pulmonary choriocarcinoma (PPC) is a rare entity with propensity to rapid metastasis and associated poor outcomes. Pleural effusion has been rarely associated with PPC. We report a case of a 23 year old nulliparous female HIV positive who present with chest pains, dry cough and pleural effusions, with leukocytosis. Poor response to antibiotics prompted further evaluation which revealed PPC with fatal metastasis. Diagnosis of PPC was reached by raised levels of beta HCG, histology and immunohistochemistry. Combination chemotherapy with radiotherapy gave some hope; - however patient demised, mostly likely due to lung metastasis. This case left doctors wondering; - what if, the diagnosis was reached earlier.