EC Clinical and Medical Case Reports

We present a postmortem case report of a 42-year-old female, who passed away 3 days post-admission following severe respiratory distress. She was 4 months postpartum after an emergency cesarean section due to fetal distress and had a 3-week history of difficulty in breathing, associated with dyspnea, hemoptysis, pleuritic chest pain, orthopnea, palpitations, and dizziness. On examination, she presented with severe respiratory distress, pallor, tachycardia, and coarse bilateral crepitations on auscultation. A working diagnosis of gestational trophoblastic disease (GTD) with lung metastases complicated by Anemia was made. Differential diagnoses included pulmonary tuberculosis, pulmonary embolism, bacterial pneumonia, congestive heart failure, and antiphospholipid syndrome. Despite treatment with oxygen therapy and antibiotics, the patient deteriorated and was declared dead following unsuccessful cardiopulmonary resuscitation. Postmortem histopathological examination confirmed a diagnosis of placental site trophoblastic tumor (PSTT) with metastases to the lungs and liver. This case highlights the diagnostic challenge posed by GTD in resource limited setting such as Uganda, and clinicians must always have suspicion in such present with lung metastases and emphasizes the importance of early recognition and management.

 Keywords: Placental Site Trophoblastic Tumor; Postmortem Diagnosis; Lung Metastases; Gestational Trophoblastic Disease; Postpartum Complications

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