Intracardiac resection of a metastatic choriocarcinoma

Background. Postpartal choriocarcinoma is a rare complication of pregnancy, which usually responds well to chemotherapy, even in advanced stages. Metastatic heart involvement typically characterizes a widely advanced disease, requiring palliative treatment. Case. A 41-year-old woman with disseminated choriocarcinoma following a full-term pregnancy presented with clinical signs of severe dyspnea. Pulmonary hypertension and a floating left atrial tumor were diagnosed upon echocardiography. Tumor resection was performed by intracardiac surgery. Histological examination revealed a metastatic thrombus of a choriocarcinoma that had obstructed the right inferior pulmonary vein at the entrance to the left atrium. The patient was treated with high-dose chemotherapy. After a 1-year follow-up the patient continues to be in full remission. Conclusion. Tumor reductive surgery followed by high-dose chemotherapy might be a useful approach in patients with metastatic choriocarcinoma even in cases of rare tumor sites. (C) 2002 Elsevier Science.