Choriocarcinoma is a gestational trophoblastic disease that carries high mortality. As this disease is highly responsive to chemotherapy, early diagnosis could lead to a favorable outcome. We report a case of metastatic pulmonary choriocarcinoma presented with hemoptysis and respiratory failure in a young woman at her third trimester. This report discusses the dilemma in deriving the diagnosis of choriocarcinoma and briefly outlines the current approaches to its treatment. Potentially life-threatening choriocarcinoma should be considered in all unusual chest radiographs of women of childbearing age. Clinicians should be aware of this possibility and proceed with the most appropriate diagnostic procedures.
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