Gestational choriocarcinoma: Rare spinal metastasis during a viable pregnancy

Abstract

Gestational choriocarcinoma metastasizing to the bones, especially to the spine, is extremely rare. In addition, there are few reports of choriocarcinoma during a viable pregnancy. We report a case of gestational choriocarcinoma that metastasized to the lumbar spine during a viable pregnancy in a 41-year-old woman with a history of a missed abortion. A heterogeneous cervical mass was detected at gestational week 16. Subsequently, a metastatic lesion appeared during the pregnancy, and fetal demise in utero occurred. Pathological examination revealed that the cervical tumor and metastatic spinal tumor were choriocarcinoma. The patient's condition deteriorated rapidly and we were unable to save her life, despite multidrug chemotherapy. Surgical tumor resection and pregnancy might involve a substantial risk of choriocarcinoma metastasis. It is important to obtain an early diagnosis for this life-threatening disease in order to facilitate appropriate treatment, despite pregnancy.

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

“…According to the reported cases, most patients with a systematic treatment based on multidrug chemotherapy combining radiotherapy and surgery ultimately ended up with death. [2,[6][7][8][9][10][11][12] Some characteristic markers of the choriocarcinoma are helpful for the accurate diagnosis, Kavanagh proposed a correlation with the upregulated levels of vascular endothelial growth factor, thought to be involved in the development of trophoblastic disease. [13] The typical imaging findings are dependent on the site of metastasis, which is associated with extensive bleeding.…”

“…[6,7] Table 1 presents all cases of reported choriocarcinoma metastases to the spine up to date. [2,[6][7][8][9][10][11][12] So far, clinically, limited cases of choriocarcinoma spine metastases have been reported. Choriocarcinoma is a chemosensitive malignant cancer with a good prognosis, even in advanced stages.…”

Incidence and prognostic factors of cranial and spinal choriocarcinomas

“…Intracranial choriocarcinomas may cause hemorrhages in the subarachnoid and intracerebral regions (12). Choriocarcinomas are rarely seen in many regions of the brain and also the spinal region (1,3). In this study, the mean age was 14.5 years (15.36 years for males and 8.5 years for females).…”

Dual-responsive, Methotrexate-loaded, Ascorbic acid-derived Micelles Exert Anti-tumor and Anti-metastatic Effects by Inhibiting NF-κB Signaling in an Orthotopic Mouse Model of Human Choriocarcinoma

“…Gestational trophoblastic neoplasia (GTN) is a spectrum of pregnancy-related malignant disorders, including invasive moles, gestational choriocarcinoma, placental-site trophoblastic tumors and epithelioid trophoblastic tumors 1-3. The most aggressive form of GTN is choriocarcinoma, which grows rapidly and tends to metastasize widely at an early stage 4-5. First-line treatment is either single-agent systemic chemotherapy or a polychemotherapy regimen of methotrexate, etoposide, actinomycin D, cyclophosphamide, and vincristine 6-7.…”