Kidney metastasis of choriocarcinoma: a case report

Choriocarcinoma is an uncommon neoplasm and it arises from the fetal trophoblast most commonly. It may develop after full term delivery, miscarriage or hydatidiform mole and demonstrate early and high incidence of metastasesto lung, brain, liver, kidney, bone and even skin. The diagnosis of the choriocarcinoma is made by the hormonal, microscopic and angiographic studies. The most frequent sites of primary metastases are lung and vaginal. Once the abdominal viscera, kidney and brain are involved, the prognosis is invariably fatal. Recently, we experienced acase of choriocarcinoma which had metastasized to lung and kidney. A 31-year-old woman was admitted to Seoul National University Hospital with the chief complaint of hematuria. She had a history of evacuation of hydatidiform mole 5 years ago. On admission, urine H.C.G. test became positive but there was no evidence of trophoblastic disease in endometrial curettage. Chest P-A showed multiple various sized nodular and streaky densitis in both sides of perihilar and peripheral lung fields. In retrograde pyelographic study, size of right kidney was enlarged and filling of calyceopelvic system was incomplete but there was no evidence of definite mass lesion. Selective renal arteriographic findings were ; a large renal tumor in upper pole of right kidney with abnormal tumor vessels, arterial encasement, aneurysmal dilatations and possible arteriovenous shunts in arterialphase, and persistent anerysmal vascular lakes in venous phase. 25 days after admission, she was performed right nephrectomy totally and confirmed as a choriocarcinoma histologically. Authors report this case with brief review of literatures.