Hemorrhage: a complication of metastatic testicular choriocarcinoma

Patients with choriocarcinoma are at risk for hemorrhage. The majority of reported cases have occurred in patients with gestational trophoblastic disease. Although choriocarcinoma in the male is a less common entity, a similar tendency exists. In 3 male patients at Memorial Sloan-Kettering Cancer Center hemorrhage developed as a direct consequence of metastatic choriocarcinoma. The blood loss was massive and resulted in the death of 2 patients. Hemorrhage occurred in two distinct settings: immediately after chemotherapy and in patients with rapidly progressive advanced disease. Early recognition and vigorous support were critical in patient management. Surgical excision of bleeding metastases may be beneficial in selected instances.