Introduction:
It is well established that Aboriginal and Torres Strait Islander people, along with others living remotely, face significant health inequity compared to their city counterparts. In this presentation I discuss a unique case of extragonadal choriocarcinoma in a 14-year-old Aboriginal male. Unfortunately, this case is an example of the ongoing health inequity that exists in rural and remote areas and it highlights the ongoing disparities faced by those living rurally in North West Queensland.
Case description and discussion:
This presentation describes the journey, and the eventual diagnosis of metastatic extragonadal choriocarcinoma, of a 14-year-old Aboriginal male from a remote community in North West Queensland. This patient presented to his home hospital on four separate occasions with fevers, diarrhoea and abdominal pain before being transferred to a level four referral centre for imaging. Upon arrival to this hospital a simple bedside ultrasound raised suspicion for intra-abdominal pathology. A subsequent CT scan revealed a solid rectosigmoid lesion with extensive lymphadenopathy and an enlarged liver filled with irregular hypodensities. Some 11 days after this patient’s first contact with the healthcare system he was transferred to the paediatric specialist hospital of the state for further investigation. Two weeks after initial presentation he underwent biopsies and 18 days later came the diagnosis of metastatic extragonadal choriocarcinoma.
Conclusion:
The lack of imaging availability in this remote area, coupled with delayed access to specialist services, likely postponed diagnosis for this patient in a way that a city counterpart would be unlikely to experience. Hence, this presentation will use this case as a platform for discussion regarding the ongoing health inequity that rural Australian’s face, with emphasis on the disparities experienced by Aboriginal people.