Unusual manifestation of metastatic gestational choriocarcinoma case report and review article

Background and Aim : Choriocarcinoma (CC) is a highly malignant tumour originating in thetrophoblastic tissue. The clinical presentation of CC is so much varied that every case may be one of itskinds and thus can be a diagnostic challenge. Numerous case reports have been published regarding theunusual clinical presentations of this cancer. We presented one case by abnormal presentation and thenreview a number of similar cases by challenging presentation.Methods : 35 years old multiparous woman admitted by abdominal pain, weakness and history of termpregnancy 6 month ago, in emergency room. At the time of refferal, her pulse rate was 120 beat per minand had abdominal tenderness. Pregnancy test was positive, haematocrit was 18 and abdominal ultrasoundshowed a50*58 cm hyperhetroechoic mass in favour of ectopic pregnancy in right adnex by moderate freefluid in pelvis. She underwent emergency laparotomy due to perforated ectopic pregnancy. Afterlaparotomy ,there was not any hemopritoan and there is gestational like mass in right ovary that resectedby hemi ovarectomy.In further investigation Beta_ hCG titrage was 33827 ,pathology report waschoriocarcinoma and in imaging ,there were distal metastasis to the lung, liver and brain .urgentchemotherapy was started for patient.Results : Extra uterine choriocarcinoma is a rare entity in it self. Cases have been reported to arise fromcervix, ovary, fallopian tube, vulva, vagina, and even in cesarean scar in female with antecedentpregnancy.Majority of cases arise from molar pregnancy and origination from other kind of pregnancy israre.30% of cases have metastatic disease at the time of diagnosis . The age of patient ranged from 17 to 67and the time between the pregnancy and choriocarcinoma varied from 4 weeks to as long as 25 years.Conclusion : Patient with gestational choriocarcinoma can present with various manifestation and it isimportant that to take in mind, in our differential diagnosis in every manifestation.

کلیدواژه ها:

gestational choriocarcinoma ، case report ، unusual presentation ، metastatic