PMC9048043_01
(A) Initial PET/CT, showing the right lung mass (solid white arrow). (B, C) Initial PET/CT, showing the mass of the lower pole of the right kidney (SUVmax = 8.7, solid blue arrow). (D) Preoperative CT shows a large subcapsular hematoma (solid red arrow).
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Immunohistochemistry detected human chorionic gonadotropin (HCG), while beta-HCG levels obtained were 279,064.00 mIU/ml. 18F-FDG PET/CT examination revealed a mass in the middle lobe of the right lung, with unevenly increased metabolic uptake (in line with the signs of lung carcinoma), with an approximate size of 5.3 cm x 5.8 cm and SUVmax of 18.3 ( Figure 1A ). Spontaneous renal hemorrhage and renal subcapsular hematoma were considered ( Figure 1D ).
The final histology shows metastatic choriocarcinoma of the kidney.
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Postoperative pathology showed that heterozygous cell nests were found in the clot, which was consistent with choriocarcinoma combined with HCG (+) on immunohistochemistry ( Figure 2 ).
Postoperative follow-up high-density CT shows surgical area marked by hemolok (solid yellow arrow). (A) Coronal CT. (B) Axial CT.
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Clinical follow-up with chest, abdominal, and pelvic CT scan at 6 and 9 months showed lung disease reduction without signs of recurrence in the kidney ( Figures 3A, B ).