Angiographic Demonstration of Arteriovenous Shunts in Pulmonary Metastatic Choriocarcinoma

Arteriovenous shunting through uterine choriocarcinoma has been well demonstrated angiographically, but, despite physiologic evidence for similar communications through metastatic nodules in the lungs, angiographic documentation has not been reported. Two cases of respiratory distress, persistent arterial oxygen desaturation, and angiographic evidence of pulmonary arteriovenous shunting in metastatic pulmonary nodules are presented. Since even the most advanced form of this disease need not have a poor prognosis, an aggressive angiographic approach may differentiate it from pulmonary embolism causing similar symptoms and findings.