Gestational choriocarcinoma in a tubal ectopic pregnancy

Bakri, Younes N.; Amri, A. El; Mulla, Jalila

doi:10.3109/00016349209007951

Cited by 15 publications

(10 citation statements)

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“…There are several previous individual case reports or small case series of hydatidiform mole occurring in tubal conceptions, but this is the largest series to review unselected population of tubal ectopic pregnancies referred with a diagnosis of possible molar GTD to a regional referral center (4)(5)(6)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). The findings of this study have demonstrated, first, that there often is initial overinterpretation of the histopathologic features of nonmolar ectopic pregnancies with the presence of florid extravillus trophoblast proliferation and early immature intermediate villi, with or without hydrops, mimicking first-trimester molar change (22).…”

Section: Discussionmentioning

confidence: 99%

Overdiagnosis of Complete and Partial Hydatidiform Mole in Tubal Ectopic Pregnancies

Sebire

Lindsay

Fisher

et al. 2005

International Journal of Gynecological Pathology

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Partial or complete hydatidiform mole (HM) affects approximately 1 in 500 to 1,000 pregnancies. Previous small series suggest that histopathologic diagnosis of HM may be difficult in tubal ectopic pregnancies. The histopathology database of a regional Trophoblastic Disease Unit was searched to identify cases with a referral diagnosis of tubal HM, and the histopathologic findings were reviewed. During the study period (1986-2004 inclusive), there were 132 cases. After central review by specialist histopathologists, the final diagnosis was ectopic partial mole in two, ectopic complete mole in five, and ectopic hydatidiform mole (not otherwise specified) in one. The final diagnosis of definite hydatidiform mole was made in eight (6%) cases, significantly less than in referred uterine curettage specimens, in which approximately 90% have a confirmatory diagnosis of HM (Z = 12.9; p < 0.0001). No cases in this series developed persistent gestational trophoblastic disease, the human chorionic gonadotropin concentration spontaneously returning to normal. Ectopic pregnancies, where managed surgically, should be submitted for histopathologic examination; however, the pathologist should be aware that the degree of extravillus trophoblastic proliferation may appear more florid compared with evacuated uterine products of conception. Molar pregnancy should only be diagnosed when strict criteria regarding morphologic abnormalities previously described in uterine evacuation material are applied.

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Section: Discussionmentioning

confidence: 99%

Overdiagnosis of Complete and Partial Hydatidiform Mole in Tubal Ectopic Pregnancies

Sebire

Lindsay

Fisher

et al. 2005

International Journal of Gynecological Pathology

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“…The incidence of choriocarcinoma with ectopic pregnancy has been reported as 2.5-4.1 %. 2 Choriocarcinoma of the fallopian tube can develop by two principal mechanisms, first, a malignant transformation of a tubal pregnancy, and second, malignancy arising denovo without an ectopic pregnancy. Choriocarcinoma occurring at the site of ectopic pregnancy in the tube was reported by Kucukozkan et al and by Bakri et al 1,2 In a study of 162 patients with gestational trophoblastic disease only 4 had the disease at the ectopic site.…”

Section: Discussionmentioning

confidence: 99%

“…2 Choriocarcinoma of the fallopian tube can develop by two principal mechanisms, first, a malignant transformation of a tubal pregnancy, and second, malignancy arising denovo without an ectopic pregnancy. Choriocarcinoma occurring at the site of ectopic pregnancy in the tube was reported by Kucukozkan et al and by Bakri et al 1,2 In a study of 162 patients with gestational trophoblastic disease only 4 had the disease at the ectopic site. 3 The presenting signs and symptoms in all cases were similar to those classically outlined for ectopic pregnancy and those that were seen in the present case.…”

Section: Discussionmentioning

confidence: 99%

Gestational Choriocarcinoma Arising from an Ectopic Pregnancy

Dahiya

Duhan

Singh

et al. 2010

Journal of Gynecologic Surgery

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Background: Gestational choriocarcinoma associated with ectopic pregnancy is an extremely rare event. This article reports a case of a choriocarcinoma arising from an ectopic pregnancy. Case: The patient was a 30-year-old woman who was admitted with pain and amenorrhoea. Ultrasonography revealed a heterogeneous mass, 5.8Â6.3 cm, in the left adnexa. At emergency laparotomy, a left salpingectomy was performed. The patient did not come for follow-up. She returned after 10 weeks with pain in her abdomen, vomiting, and a pelvic mass. Relaparotomy was done. On separating the adhesions, an organised blood clot of *700 cc, along with some tissue, were removed from the pouch of Douglas. Active bleeding started from the raw surface; this bleeding could not be controlled. Hence, the bilateral iliac artery and ovarian artery were ligated. Histopathologic investigation revealed choriocarcinoma. Conclusions: A choriocarcinoma is a malignant tumor that arises from the epithelium of the chorionic villi. Associated with ectopic pregnancy, this kind of tumor is extremely rare and is generally very aggressive. In 75% of cases, it items from distant metastasis; therefore, a histologic examination of the tubes must be performed in all ectopic pregnancies. ( J GYNECOL SURG 26:273)

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“…There are authors who defend a complete adnexectomy rather than partial, followed by chemotherapy (1,6,7) . Other authors defend the idea of an adnexectomy and bilateral resection of the theca lutein ovarian cysts, followed by chemotherapy (8) .…”

Section: Discussionmentioning

confidence: 99%

Primary tubal choriocarcinoma

Gálvez

Fernández

Reyes

et al. 2004

Int J Gynecol Cancer

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Choriocarcinoma is one of the most serious forms of gestational trophoblastic tumor. It is a malignant tumor from the epithelium of the chorionic villi. The most frequent location site is the uterus. Associated with ectopic pregnancy, it is extremely rare and in general, very aggressive. In 75% of the cases, it items from distant metastasis; therefore, a histological examination of the tubes must be performed in all ectopic pregnancies. Our patient was a 33-year-old woman who was admitted to emergency room (ER) with an intense pain in the right, iliac cavity, and limited genital bleeding. During the exploration, there was abdominal pain, with doubtful signs of peritoneal irritation. The vaginal ultrasound offered an image that was compatible with an extra uterine pregnancy in the left appendages. At emergency, right salpingectomy was performed via laparotomy. The patient was treated with polychemotherapy and contraceptives for a year, with no recurrence of the disease. Control follow-up was performed using beta-human chorionic gonadotropin (HCG) testing on a weekly basis during the first month and then bi-monthly during the first year of follow-up.

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Gestational choriocarcinoma in a tubal ectopic pregnancy

Cited by 15 publications

References 0 publications

Overdiagnosis of Complete and Partial Hydatidiform Mole in Tubal Ectopic Pregnancies

Overdiagnosis of Complete and Partial Hydatidiform Mole in Tubal Ectopic Pregnancies

Gestational Choriocarcinoma Arising from an Ectopic Pregnancy

Primary tubal choriocarcinoma

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