Metastatic Choriocarcinoma Causing Intussusception: A Rare Case Study
Explore a unique case involving a 32-year-old woman of Australian heritage presenting with black stools, abdominal pain, and metastatic choriocarcinoma leading to jejeunal intussusception. Discover the diagnostic journey, treatment approach, and key learning points associated with this uncommon condition.
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Delivering and Receiving Wasim Hakim ST2 Clinical Radiology Imperial College Healthcare NHS Trust
Wasim Hakim Dan West Simon Gill Mary Roddie Dominic Blunt Charing Cross Hospital Fulham Palace Road, London Correspondence: wasim.hakim@imperial.nhs.uk
Clinical information 32-year-old lady of Native Australian heritage PC: Tiredness and a 7-day history of black stools & abdominal pain PMH: Nil DH: Nil SH: Non-smoker, minimal alcohol intake & looked after her infant and toddler full-time FH: Nil
Contrast-enhanced CT - coronal reconstruction of the abdomen & pelvis taken in the portal venous phase
Portal venous CECT axial & coronal reconstruction 7 day follow-up
Diagnosis In addition to the rapidly enlarging liver lesion, she had multiple lung lesions 4-months post-partum Beta-hCG 77,000 IU/L Metastatic choriocarcinoma causing jejeunal intussuception
Discussion Intussusception when bowel receives itself by peristalsis, often with an intraluminal mass leading it. File:Intussusception EN.svg
Discussion (2) Gestational trophoblastic disease Chorionic epithelium from preceding pregnancy Aggressive vascular tumours Metastases to brain, lung, bowel, pancreas Prone to bleeding tends to be per vaginal Chemotherapy is the mainstay of treatment, often with a prompt response Charing Cross Hospital File:2910 The Placenta-02.jpg
Key Learning Points Target sign of intussusception In adults must look for a tumour lead-point Rare Young lady, with aggressive bleeding metastases, the differential is small
References Radiopaedia.org Yokoi K, Tanaka N, Furukawa K et al. Male choriocarcinoma with metastasis to the jejunum: a case report and review of the literature. J Nippon Med Sch 2008; 75: 115-117 Iyomasa S, Senda Y, Mizuno K et al. Primary choriocarcinoma of the jejunum: report of a case. Surg Today 2003; 33: 948-951 Discussion images are free to use from wikipedia.org
