Metastatic Choriocarcinoma With Tumor Thrombus in the Right Atrium and Pulmonary Vessels

We report the case of an asymptomatic 38-year-old woman with persistent choriocarcinoma, based on the results of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET/CT) followed by CT pulmonary angiography, a diagnosis of metastatic right atrial tumor thrombus with pulmonary tumor thromboemboli was made. The patient underwent aggressive salvage chemotherapy with a combination of 5 drugs (ifosfamide, cisplatin, etoposide, vinblastine, and bleomycin) and responded to therapy which was objectively documented by the F-18 FDG PET/CT imaging. Thus FDG-PET/CT is a useful modality for demonstrating metastatic tumor thrombi noninvasively, mapping the extent of metastasis and assessing the response to therapy objectively.