Case Report Gastrointestinal Bleeding Secondary to Metastatic Duodenal Choriocarcinoma in a Patient with Concomitant Peptic Ulcer Disease Ahmed Elfiky , 1 Asmaa Mokhtar, 1 Mira Alsheikh, 2 Hassan Almoussawi, 2 and Stephen Mulrooney 2 1 Department of Internal Medicine, Staten Island University Hospital-Northwell Health, New York, NY, USA 2 Department of Gastroenterology, Staten Island University Hospital-Northwell Health, New York, NY, USA Correspondence should be addressed to Ahmed Elfiky; aelfiky1@northwell.edu Received 31 October 2020; Accepted 23 February 2021; Published 3 March 2021 Academic Editor: Haruhiko Sugimura Copyright © 2021 Ahmed Elfiky et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Testicular tumors are one of the most common solid tumors in young males. Choriocarcinoma usually presents as metastatic disease. Gastrointestinal tract involvement is rare. We report a case of a 40-year-old male presenting to our hospital with a three- day history of dyspnea on exertion and black stool after recent diagnosis of testicular choriocarcinoma. Urgent EGD performed revealed small clean-based fundal ulcer and an antral ulcer without the stigma of recent bleeding. Capsule endoscopy was performed and revealed a bleeding ill-defined mass in the proximal duodenum. A subsequent push enteroscopy showed an ulcerated bleeding mass in the third part of the duodenum that was treated with a hemospray with adequate hemostasis. Pathology was consistent with pure choriocarcinoma. e patient received a cisplatin-based chemotherapy regimen. e patient tolerated the chemotherapy regimen well and was discharged for outpatient follow-up. At the three-month follow-up, the patient did not show evidence of recurrent gastrointestinal bleeding. 1. Introduction Testicular tumors are one of the most common solid tumors in males aged 15–35 years, with germ cell tumors being the most common type [1]. Choriocarcinoma, the most aggressive subtype, usually presents with metastasis owing to the frequent hematogenous and lymphatic spread. e most common sites of metastasis are the lungs, liver, brain, and bone [2]. Gas- trointestinal tract involvement is rare. We report a case of a 40- year-old male presenting with upper gastrointestinal bleed secondary to metastatic duodenal choriocarcinoma. 2. Case Description A 40-year-old male presented to the hospital with a three- day history of dyspnea on exertion and black stool. He was recently diagnosed with testicular choriocarcinoma and lung metastasis. He underwent left radical orchiectomy ten days prior to admission. e pathology revealed choriocarcinoma with immunopathological stain positive for human cho- rionic gonadotropin. e patient was in the process of evaluation for chemotherapy at the time of the presentation. Vital signs upon presentation were notable for a heart rate of 122/minute, otherwise stable. Physical exam was significant for mild epigastric tenderness and melena on the digital rectal exam. Initial blood work revealed acute microcytic anemia with a hemoglobin of 8.4 g/dL. Hemoglobin three weeks before the presentation was 14 g/dL. Upper gastro- intestinal bleeding was suspected; the patient was resusci- tated and started on pantoprazole infusion. Urgent esophagogastroduodenoscopy (EGD) performed after 10 hours of presentation with the finding of one small clean based fundic ulcer and a 2 cm antral ulcer without the stigma of recent bleeding. Because of persistent melena and a drop in the hemo- globin level requiring transfusion of 2 pRBCs, colonoscopy Hindawi Case Reports in Gastrointestinal Medicine Volume 2021, Article ID 6664147, 3 pages https://doi.org/10.1155/2021/6664147