A 30-year-old woman with no significant medical history, presented with subacute onset dyspnea for 1 month. At presentation, her physical examination revealed tachycardia, bilateral lung crackles and a faint S3 on chest examination. Abdominal examination showed lower abdominal distension.
Highly vascular abdomino pelvic mass with ? A-V shunting and high output heart failure
FD: MRI abdomen showed abnormal serpentine uterine and parametrial vessels (arrow) that mostly replaced the uterus. These enhance in both the arterial and venous segments in the arterial phase. This is consistent with massive uterine arteriovenous malformations…
This resulted in high output cardiac failure
Histopathology revealed mass to be gestational trophoblastic disease.