Hurricane growth of malignant trophoblastic teratoma

The case history of a 27 year old male ex-intravenous drug user who presented with haemoptysis and indistinct lung shadowing is reviewed. During a 3 week period of investigation his lung shadowing increased dramatically and it became apparent that he had metastases from chorionic gonadotropin-producing testis cancer which had undergone spontaneous regression of the primary tumour. Unfortunately by the time he was referred for treatment he was in respiratory failure and died 48 hours after treatment started. The critical importance of the urinary pregnancy test (available in most casualty departments to diagnose ectopic pregnancy) in accelerating diagnosis and treatment of such a case is highlighted.