Metastatic trophoblastic disease masquerading as pulmonary embolism

A 51-year-old woman presented with a 2-week history of dyspnoea, dry cough and fever which did not improve with a course of oral antibiotics. Her past medical history was significant for a termination of pregnancy more than 5 years previously and a total hysterectomy and bilateral salpingo-oophorectomy shortly thereafter for infarcted fibroids. Physical examination revealed decreased breath sounds over the left lower chest. The chest radiograph showed infiltrates in the left lower zone associated with a small pleural effusion. …