Ovarian nongestational choriocarcinoma and associated adenocarcinoma with the same germ cell origin determined by a molecular genetic approach: A case report

Abstract

Ovarian non-gestational choriocarcinomas co-existing with adenocarcinoma are extremely rare and have been reported as epithelial ovarian carcinomas of a "non-germ cell origin" with "choriocarcinomatous differentiation". Although the cellular origin of non-gestational choriocarcinoma may be post-meiotic ovarian germ cells or the dedifferentiation of epithelial ovarian carcinoma, detailed genetic evidence has not yet been obtained to support this. We herein present a case of ovarian non-gestational choriocarcinoma co-existing with adenocarcinoma in a 29-year-old woman. The tumor rapidly increased in size and lung metastases appeared soon after parturition. We genetically demonstrated that the cellular origin of ovarian non-gestational choriocarcinoma was a post-meiotic germ cell derivation using a short tandem repeat analysis. The co-existing adenocarcinoma component was also shown to be of the same germ cell origin. These tumors showed the same homozygous pattern. A molecular genetic approach may be important for understanding the clinicopathological features of such tumors.

Pure primary non-gestational choriocarcinoma originating in the ovary: A case report and literature review

“…Most of primary NGCO occurs in admixtures with teratomas, endodermal sinus tumors, embryonal carcinomas, or dysgerminoma. 8 – 10 Pure non-gestational choriocarcinoma is extremely rare, 4 originates from pure germ cells of the ovary, has no association with pregnancy, 11 most frequently occurs in adolescents and young females, and is occasionally found in postmenopausal women. 12 …”

“…Most of primary NGCO occurs in admixtures with teratomas, endodermal sinus tumors, embryonal carcinomas, or dysgerminoma. [8][9][10] Pure nongestational choriocarcinoma is extremely rare, 4 originates from pure germ cells of the ovary, has no association with pregnancy, 11 most frequently occurs in adolescents and young females, and is occasionally found in postmenopausal women. 12 Clinical manifestations of NGCO include abdominal pain, pelvic masses, 12 bleeding per vaginum, amenorrhea, nausea, vomiting, weight loss, micturition disturbances, elevated serum β-hCG levels, precocious puberty, and endocrine abnormalities.…”

Short tandem repeat analysis for confirmation of uterine non-gestational choriocarcinoma in a postmenopausal Taiwanese woman

“…The genotype of our patient's tumor cells was solely maternal, providing substantial evidence of nongestational choriocarcinoma. Most of the reported cases of choriocarcinoma in the literature were derived from nongestational ovarian tissue, [ 1 , 2 , 8 ] whereas only 1 reported case was derived from the uterus. [ 8 ] In our patient's case, the endometrium near the tumor revealed focal atypical endometrial hyperplasia, with areas of pseudo-decidualization of endometrial stroma.…”

Accurate short tandem repeat analysis for confirmation of rare gestational adrenal choriocarcinoma: a case report

“…However, these methods mislead doctors sometimes because both of the detections can’t give an accurate diagnosis, which could lead to false treatment ( 6 , 7 , 12 ). According to what we have studied, some researchers used STR as a method to identify nongestational choriocarcinoma ( 5 , 6 , 13 , 14 ). However, they are all about choriocarcinoma in genital system.…”