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Multi-organ Metastatic Choriocarcinoma with Rare Presentation of Small Bowel Intussusception

Raza Sayani, Nauman Al Qamari, Rabail Raza, Zishan Haider and Aamir Sharif

We report the case of a 30-years-old lady who presented with primary complains of GI bleed since 4 months. Her upper and lower GI endoscopies were inconclusive due to luminal blood. CT scan abdomen showed multi organ haemorrhagic lesions, including liver, lung, spleen, kidneys and bowel. The lesion in small bowel was leading to intussusception. No definite arterial extravasation was seen. Her RBC tag was also negative. Due to continuous bleeding and her clinical condition she was advised for angiography which demonstrated vascular lesions in the small bowel. These were embolized to reduce vascularity and bleeding. Post embolization, the patient had to be shifted for laparotomy due to abdominal pain. Resection and anastomosis with temporary ileostomy was performed due to multiple small bowel lesions and biopsy from liver was also performed. Histopathology report showed choriocarcinoma. Her consciousness level deteriorated and CT scan of brain was done which showed metastatic lesions in brain. Patient’s condition continued to deteriorate and she died few days later.