Ultrasound image of choriocarcinoma

Patient with stage 3 choriocarcinoma after term pregnancy. Transverse transvaginal image of the uterus shows an echogenic mass (calipers) with cysts. The mass in predominantly in the myometrium, separate from the thin echogenic endometrium. Based on ultrasound appearance alone, this could be choriocarcinoma or retained products of conception in a patient with placenta accreta spectrum. Pulmonary metastases on chest radiograph support the diagnosis of choriocarcinoma.