A lesson from a rare cause of pulmonary embolism.

Pulmonary embolism may be a life-threatening condition that needs immediate medical intervention. Early detection plays an important role in improving the survival rate. However, pulmonary embolism is a difficult diagnosis that may be missed because of non-specific clinical presentation. According to guidelines on the diagnosis and management of acute pulmonary embolism, it should be diagnosed by the combination of the clinical presentation, radiological detection, and blood test such as D-dimer. Generally, anticoagulant therapy is the mainstay of treatment in most cases of pulmonary embolism. Massive or submassive pulmonary embolism causing hemodynamic instability is the indication for thrombolysis or embolectomy.1 Most commonly, pulmonary embolism is caused by venous thromboembolism; however, other diseases, such as metastatic tumor, septic emboli, and foreign bodies, can mimic pulmonary thromboembolism. Choriocarcinoma is a malignant, trophoblastic tumor characterized by early hematogenous spread to the lungs. Bagshawe and Brooks were the first to document pulmonary embolism attributable to choriocarcinoma.2 Because pulmonary metastatic choriocarcinoma can mimic pulmonary thromboembolism, it makes the differential diagnosis very challenging. We report a 24-year-old woman with pulmonary embolism caused by pulmonary metastatic choriocarcinoma. Case Summary