Late Presentation of Primary Choriocarcinoma Lung in a Young Male

Abstract

Primary Choriocarcinoma of the lung is a rare malignant tumor in young patients. It is mostly misdiagnosed as primary or metastatic lung cancer. Poor outcome is seen due to delays in treatment and aggressive behavior of the tumor. We present an 18-year-old male the complaints of chest pain, backache, and hemoptysis. He denied any history of tuberculosis or malignancy though he confirmed to be an occasional smoker.  He was tachypneic with decreased air entry bilaterally and the rest of the examination was normal. Investigations revealed multiple bilateral pulmonary nodules. Intraoperatively multiple brown sub-centimeters to more than one-centimeter lung nodules were observed. Histopathology was suggestive of Choriocarcinoma of the lung. Beta-HCG was positive with workup for distant metastasis suggestive of para-aortic lymph node invading left psoas muscle. He was referred to oncology where he expired due to widespread disease and chemotherapy side effects.