Intracardiac resection of a metastatic choriocarcinoma.
BACKGROUND
Postpartal choriocarcinoma is a rare complication of pregnancy, which usually responds well to chemotherapy, even in advanced stages. Metastatic heart involvement typically characterizes a widely advanced disease, requiring palliative treatment.


METHODS
A 41-year-old woman with disseminated choriocarcinoma following a full-term pregnancy presented with clinical signs of severe dyspnea. Pulmonary hypertension and a floating left atrial tumor were diagnosed upon echocardiography. Tumor resection was performed by intracardiac surgery. Histological examination revealed a metastatic thrombus of a choriocarcinoma that had obstructed the right inferior pulmonary vein at the entrance to the left atrium. The patient was treated with high-dose chemotherapy. After a 1-year follow-up the patient continues to be in full remission.


CONCLUSIONS
Tumor reductive surgery followed by high-dose chemotherapy might be a useful approach in patients with metastatic choriocarcinoma even in cases of rare tumor sites.
Bohlmann
Michael K
MK
Clinic for Cardiovascular Surgery, University Hospital Berne, Switzerland. michael.bohlmann@med.uni-heidelberg.de
Eckstein
Friedrich S
FS
Allemann
Yves
Y
Stauffer
Edouard
E
Carrel
Thierry P
TP
D000328:Adult; D002822:Choriocarcinoma / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery