Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.
Ann Thorac Surg. 2019 Aug;108(2):e115-e117. doi: 10.1016/j.athoracsur.2018.12.038. Epub 2019 Jan 24.
This report presents the case of an apparently healthy female patient with a history of placenta accreta who was transferred from an outside hospital with the chief complaint of shortness of breath and a large spontaneous hemothorax requiring surgical exploration. Resection of a large, bleeding lower lobe mass identified metastatic gestational choriocarcinoma, a previously unreported cause of spontaneous hemothorax and an equally rare consequence of placenta accreta. The identification of novel genomic features associated with gestational choriocarcinoma allowed for confirmation of this subtype, which has clinical implications for surveillance and prognosis after treatment with adjuvant therapy.
本报告介绍了一例看似健康的女性患者,她曾患有胎盘植入病史,因呼吸困难和大量自发性血胸需手术探查而从外院转入。切除一大块出血的下叶肿块后,诊断为转移性妊娠绒癌,这是自发性血胸的一个以前未报道的原因,也是胎盘植入的罕见后果。与妊娠绒癌相关的新型基因组特征的鉴定证实了这一亚型,这对辅助治疗后进行监测和预后具有临床意义。