title: [Recurrent miscarriage turns out to be lung cancer].
abstract: BACKGROUND
  If a positive pregnancy test is followed by profuse vaginal bleeding, the diagnosis of miscarriage can generally be made. Sometimes, however, elevated hCG levels may be associated with a phantom pregnancy, which may be a paraneoplastic symptom.
  
  
  METHODS
  A 27-year-old woman was referred for a diagnosis after having experienced 3 consecutive miscarriages. The diagnostic workup could not identify an underlying cause. After 3 more biochemical miscarriages, the original diagnosis was called into question and extensive testing for ectopic hCG production was performed. It appeared that the false pregnancies were paraneoplastic symptoms of an hCG-producing non-small cell lung cancer. After a lobectomy, the hCG levels returned to normal and a spontaneous pregnancy and uncomplicated delivery followed.
  
  
  CONCLUSIONS
  Phantom pregnancy as a paraneoplastic symptom is extremely rare, but should be considered in patients presenting with recurrent, non-objectifiable miscarriages. Careful documentation of the menstrual cycle is necessary for early detection of the condition. The fact is that vaginal bleeding after a positive pregnancy test can still be a normal menstruation.
authors.affiliation: Canisius Wilhelmina Ziekenhuis, Nijmegen.
authors.forename: Inge M W
authors.initials: IM
authors.lastname: Ebisch
authors.forename: Gijs J M
authors.initials: GJ
authors.lastname: Limonard
authors.forename: Willem
authors.initials: W
authors.lastname: Vreuls
authors.forename: Jan M J
authors.initials: JM
authors.lastname: Sporken
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis; D000328:Adult; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis*; D006063:Chorionic Gonadotropin / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis*; D011247:Pregnancy; D014592:Uterine Hemorrhage
chemical_list: D006063:Chorionic Gonadotropin