Testicular Choriocarcinoma Presenting with Massive Hemoptysis and Endobronchial Metastases

Abstract

Introduction: Pure testicular choriocarcinoma is a rare type of non-seminomatous germ cell tumors that affects young males, occurring in less than 1-5% of testicular cancers. It is the most aggressive form of germ cell tumors and tends to metastasize hematogenously to the lungs, liver, brain and other visceral organs with the testicular primary tumor can be small or burnt out. It responds to chemotherapy but carries high mortality rate.                                                             

Presentation of case: we report a case of 20 year-old otherwise healthy male who presented to the emergency department with massive life-threatening hemoptysis secondary to metastatic pure testicular choriocarcinoma, including endobronchial metastases. He responded remarkably to cisplatin-based chemotherapy followed by radical orchiectomy resulting in ongoing remission.              

Conclusion: This case illustrates the clinical course of a young male with advanced primary testicular choriocarcinoma presenting with massive hemoptysis secondary to lung metastasis including endobronchial metastasis, which responded to cisplatin-based chemotherapy. Early recognition, joint management by intensivists, oncologists and urologists, and prompt initiation of cisplatin-based chemotherapy followed by orchiectomy forms the cornerstone of management.