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Acute presentation of choriocarcinoma: a case study and review of the literature

Published online by Cambridge University Press:  21 May 2015

Andrew Worster ,
Sangita Sharma ,
Farouk Mookadam  and
John Opie
Andrew Worster*
Affiliation:
Departments of Emergency Medicine, Medicine, Hamilton Health Sciences Corporation and McMaster University, Hamilton, Ont.
Sangita Sharma
Affiliation:
Medicine, Hamilton Health Sciences Corporation and McMaster University, Hamilton, Ont.
Farouk Mookadam
Affiliation:
Department of Cardiovascular Disease, The Mayo Clinic, Rochester, Minn
John Opie
Affiliation:
Departments of Emergency Medicine, Medicine, Hamilton Health Sciences Corporation and McMaster University, Hamilton, Ont.
*
Division of Emergency Medicine, Hamilton Health Sciences, 237 Barton St. E, Hamilton ON L8N 3Z5; 905 521-2100 x73136, fax 905 527-7051, aworster@rogers.com

Abstract

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We report an unusual case of a 27-year-old male with an acute presentation of choriocarcinoma. The patient presented with unstable vital signs, severe anemia and a widened arterial pulse pressure following a several day history of testicular pain. He was subsequently diagnosed as having testicular choriocarcinoma with multiple hepatic metastases and large hemorrhagic para-aortic lymph nodes. The widened pulse pressure persisted during fluid resuscitation and correction of both the anemia and hypotension, and only narrowed after the initiation of chemotherapy. A literature review indicates that metastatic testicular choriocarcinoma is a rare but aggressive malignancy that often presents with acute symptoms and signs that cause patients to seek emergency care. We summarize the reported cases of “acute” testicular choriocarcinoma presentation and briefly discuss its relationship to widened arterial pulse pressure.

Keywords

choriocarcinomatesticular neoplasmspulse pressureshockemergency medicine
Type
Case Report • Observations
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 2 , March 2002 , pp. 111 - 114
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

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