Infantile choriocarcinoma: a case report with MRI, angiography and bone scintigraphy

Abstract

Infantile and maternal choriocarcinoma is a very rare disease. We report a case with the characteristic clinical features of infantile choriocarcinoma: developing anemia, hemorrhagic liver tumors, rapid progression to death and maternal choriocarcinoma. Bone scintigraphy showed increased uptake by the liver tumors. In this case there were two possible primary sites: the placenta of this pregnancy and a hydatidiform mole that had been present 2 years previously.

Solitary infantile choriocarcinoma of the liver: MRI findings

“…Most infantile cases of choriocarcinoma occur between 5 weeks and 7 months of age or at term [1,5]. Early dissemination and intractable disease require rapid diagnosis and treatment [1,4]. Common sites of metastases for infantile hepatic choriocarcinoma are lung, kidney, brain and lymph nodes.…”

“…Few studies have described the imaging findings of infantile hepatic choriocarcinoma [1,2,4,5]. Although MRI is very sensitive for tumour detection and gives detailed anatomical information, the signal characteristics are non-specific.…”

“…Choriocarcinomas usually show strong and irregular peripheral enhancement without central tumoural enhancement. Consequently, in the absence of a known maternal choriocarcinoma, the tumour is usually misdiagnosed as hepatoblastoma, hemangioendothelioma, mesenchymal hamartoma, metastatic neuroblastoma or as undifferentiated hepatic sarcoma [2,[4][5][6].…”

“…Witzleben and Bruninga [3] described this as early as 1968 as 'infantile choriocarcinoma syndrome'. Few studies have described the imaging characteristics of choriocarcinoma [1,2,4,5]. Frequently, the tumour is misdiagnosed as hepatoblastoma, hemangioendothelioma, mesenchymal hamartoma, metastatic neuroblastoma or undifferentiated hepatic sarcoma [2,5,6].…”

Infantile Choriocarcinoma of the Liver: Case Report and Review of the Literature

“…To our knowledge, there are 32 cases in the English literature and all the published 32 cases are case reports [1][2][3][4][5][6][7][8]. Infantile choriocarcinoma of the liver is an extremely rare tumor originating in the placenta during gestation and detected in the perinatal and early infancy period as a hepatic mass.…”