The patient's first pregnancy, in 1953, terminated at five and one-half months with the expulsion of a mass that was described, on the basis of microscopic examination, as a benign hydatiform mole. Five years later, after repeated pulmonary complaints, the patient was found to have infiltration of the left lung field and left pleural effusion. After hospitalization, her condition deteriorated steadily. Postmortem examination confirmed the clinical impression of multiple pulmonary infarction and cor pulmonale. The infarcts were due to choriocarcinomatous tumor thrombi originating from a Y-shaped saddle type of trophoblastic tumor obstructing the pulmonary arteries bilaterally. It is unlikely that administration of chorionic gonadotropin to the patient in the five-year interval for infertility stimulated trophoblastic proliferation, but this possibility cannot be entirely excluded.
Robert J. Fahrner, Andrew J. McQueeney, Jack M. Mosely, Robert W. Petersen. TROPHOBLASTIC PULMONARY THROMBOSIS WITH COR PULMONALEREPORT OF A CASE DUE TO MALIGNANT HYDATIFORM MOLE OF FIVE YEARS' DURATION. JAMA. 1959;170(16):1898–1901. doi:10.1001/jama.1959.03010160014005