Pneumon 2018, 31(4):240 Images in Pulmonology
Haemorrhagic pulmonary metastases due to choriocarcinoma syndrome
Authors Information
1 Pulmonary Department,
2 Radiology Department,
Oncology Department, 424 General Military Hospital (424 GMHT), Thessaloniki, Greece
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A 55-year-old male patient under chemotherapy for metastatic testicular choriocarcinoma presented in the emergency department of our hospital due to dyspnea and haemoptysis. Chest CT scan revealed a halo of ground glass opacity around most of the preexisting multiple secondary masses and nodules, indicative of peritumoral haemorrhage (CT halo sign) (Fig. 1-3).

Choriocarcinoma is well known to cause haemorrhagic pulmonary metastases, along with angiosarcoma, renal cell carcinoma and melanoma.Testicular choriocarcinoma is a rare agressive type of non-seminomatous germ cell tumor.

‘Choriocarcinoma syndrome’ is a special feature of choriocarcinoma, first described by Logothetis in 1984, characterised by markedly elevated serum beta-subunit human chorionic gonadotropin (β-hCG) and bleeding in metastatic sites, due to high volume of choriocarcinomatous elements1. Similarly to our patient’s case , acute pulmonary haemorrhage is choriocarcinoma syndrome΄s most common manifestation, but bleeding can occur in any metastatic site, always representing a medical emergency, linked to high mortality and requiring prompt and intensive supportive care2.

No funding or conflict of interest is declared.

All authors are in agreement with the manuscript.


1. Logothetis CJ. The choriocarcinoma syndrome. Cancer Bul 1984; 36:118-20.
2. Reilley MJ, Pagliaro LC. Testicular choriocarcinoma: a rare variant that requires a unique treatment approach. Current Oncology Reports 2015; 17:2. doi: 10.1007/s11912-014-0430-0.