Role of thoracotomy in pulmonary metastases from gestational choriocarcinoma.

Choriocarcinoma responds well to chemotherapy, and its growth can be monitored by measuring human chorionic gonadotropin (HCG) as a tumor marker. Thoracotomy was carried out in six patients with the disease because their pulmonary nodules persisted after repeated courses of chemotherapy over a 4 month period. They were followed up for a long period. These observations suggest that the most important role of thoracotomy is for diagnostic purposes; it is used for therapeutic purposes only when the pulmonary lesion is the only remaining source of increased HCG excretion. Much attention must be paid to tertiary hematogeneous metastases caused by resection of pulmonary foci that are unresponsive to chemotherapy.