Choriocarcinoma After Full-Term Pregnancy: A Case Report and Review of the Literature

Abstract

Choriocarcinoma is a disease associated with uncontrollable proliferation and malignant change of cells of the placenta and belongs to the malignant end of the spectrum in gestational trophoblastic disease. These tumours are usually developed after molar pregnancies, and their incidence after full-term pregnancies is extremely rare.We present a very rare case of a 30-year-old lady, admitted with a five-month history of vaginal bleeding after a normal pregnancy. The human chorionic gonadotropin (hCG) was at a level of 209,566. A pelvic ultrasound scan revealed an endometrial thickness of 6 cm and the presence of an intra-uterine mass measuring 56 × 50 × 45 mm. After discussion with the regional gestational trophoblastic disease centre, we proceeded to a surgical evacuation of the uterus, which confirmed a post-partum choriocarcinoma (International Federation of Gynaecology and Obstetrics (FIGO) score 9). Care was continued in the specialised centre with multi-agent chemotherapy. The response was excellent, and the patient was subsequently discharged after 10 cycles of chemotherapy, and a 10-year follow-up was arranged.Choriocarcinomas after full-term pregnancies are a rare entity. Even when they happen, they are usually associated with pregnancy complications in the ante-natal period. The prognosis is usually very good, provided that prompt diagnosis and referral to a specialised centre are made. Low-risk patients are usually treated with methotrexate monotherapy, whereas high-risk women would normally require multi-agent chemotherapy.The diagnosis of choriocarcinoma might be proven challenging even for experienced clinicians. Women should be informed that the prognosis is usually excellent, provided that they receive the right treatment.

A Case Series of Gestational Choriocarcinoma with Review of Literature

“…2 GTN is a rare human tumor that can be cured even in the presence of widespread dissemination. 7 In all our cases, FIGO score ranged from 8 to 13, belonged to high-risk group. EMACO was the first line of choice for multidrug chemotherapy in our cases.…”

Rapid Evolution of a Case of Choriocarcinoma Following Normal Delivery at Term Pregnancy

“…Did hormonal contraception hurry the evolution of the tumor? A case of choriocarcinoma is reported in a patient who used the Mirena IUS intrauterine device with good prognosis [1]. For our case metrorrhagia episods were the first s manifestations requiring curettage (no anatomopathological exam provided of the removed products), despite this act the metrorrhagia continued.…”

Pulmonary metastatic gestational choriocarcinoma following an uncomplicated term pregnancy: a case report

“…CC is an aggressive neoplastic disease of the chorionic membranes [ 1 ]. Metastatic CC in a patient after a term pregnancy is extremely rare and the outcome is strongly dependent on clinical doubt and immediate chemotherapy regimen initiation [ 3 , 8 ]. Any delay in the diagnosis can worsen the patient outcome, and we suggest that clinicians should consider CC in their differential diagnosis, especially after a term and nonmolar pregnancy.…”

“…Choriocarcinoma (CC) is an aggressive neoplastic disease of the chorionic membranes. This trophoblastic disease is usually suspected after postpartum hemorrhage associated with increased levels of human chorionic gonadotropin (HCG) [ 3 – 5 ].…”

“…Pulmonary metastatic CC usually presents with dyspnea, pleural effusion, and pleuritic pain [ 6 , 7 ]. The incidence of CC after a term pregnancy is really rare (1/160,000 pregnant women) [ 3 , 8 ]. This study aimed to report a case of pulmonary metastatic CC after an uncomplicated term pregnancy in a 20-year-old woman, who was admitted to our hospital with sudden onset dyspnea and pain in the left hemithorax the day after her labor.…”