Maternal and neonatal death from advanced choriocarcinoma due to a delay in diagnosis: a case report.
BACKGROUND
Metastatic choriocarcinoma rarely coexists with a normal pregnancy.


METHODS
A 36-year-old multipara presented to the hospital at 23 weeks' gestation with progressive dyspnea and tachycardia. She was admitted and evaluated by the Psychiatry Department for presumed panic disorder and had perinatology, pulmonary, cardiology and infectious disease consultations. Over the course of 5 days she developed respiratory failure, delivered a nonviable infant and died from complications of metastatic pulmonary choriocarcinoma. Choriocarcinoma was not considered in the differential diagnosis of the respiratory failure until the day prior to the patient's death.


CONCLUSIONS
Choriocarcinoma, although rare, should be considered in the differential diagnosis of pregnant women presenting with abnormally elevated serum beta-human chorionic gonadotropin levels and respiratory failure.
Parks
D Gene
DG
Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, USA. gparks@mednet.ucla.edu
D000328:Adult; D002822:Choriocarcinoma / Q000097:blood / Q000175:diagnosis*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011247:Pregnancy; D012128:Respiratory Distress Syndrome / Q000209:etiology; D013997:Time Factors; D014594:Uterine Neoplasms / Q000097:blood / Q000175:diagnosis*
D018997:Chorionic Gonadotropin, beta Subunit, Human