Primary Hepatic Choriocarcinoma: A Rare Cause of Spontaneous Haemoperitoneum in an Adult

Abstract

Choricarcinoma is a beta human chorionic gonadotrophin secreting neoplasm pertinent to uterus and pregnancy mostly. It occurs primarily in gonads but rarely in extragonadal sites. Primary hepatic choriocarcinoma is an extremely rare tumor. Most of the reported cases are seen in infants representing metastasis from an occult placental choriocarcinoma. Till date, only 7 cases of primary hepatic choriocarcinoma in adults have been reported in literature. We present a case of a 40-yearold male presenting as haemoperitoneum due to ruptured hepatic tumor. He underwent emergency left lateral segmentectomy. He died on 10th postoperative day. The surgical specimen and autopsy findings confirmed it to be primary hepatic choriocarcinoma. This is the first case report from Indian Subcontinent. A brief case report and review of literature is presented.

Primary hepatic choriocarcinoma in an 83‐year‐old woman

“…First, primary hepatic choriocarcinoma frequently metastasizes within the liver; multinodular tumors were observed in 6 of 11 cases (Table ). Second, this carcinoma metastasizes to the stomach and spleen . Our patient had a tumor in the stomach and tumor thrombus in the splenic vein.…”

“…Second, this carcinoma metastasizes to the stomach and spleen. 5,7 Our patient had a tumor in the stomach and tumor thrombus in the splenic vein. We hypothesized that portal hypertension induced by tumor thrombus in the portal vein probably caused metastasis into the gastric wall.…”

“…Third, this tumor often metastasizes to the para‐aortic lymph nodes. HCC rarely spreads through the lymphatic system, but three patients with primary hepatic choriocarcinoma have had lymph node spread . Interestingly, there have been no reported cases of primary hepatic choriocarcinoma spreading to the thoracic lymph nodes.…”

“…These tumors have also been associated with early hematogenous and lymphatic metastasis and resistance to anticancer drugs, leading to an extremely poor prognosis. Non‐gestational choriocarcinomas are extremely rare but have been reported in the testis, ovary, lung, liver, and gastrointestinal tract . Primary hepatic choriocarcinoma is particularly rare, with only 10 reported cases, mostly from China and Japan .…”

“…Non-gestational choriocarcinomas are extremely rare but have been reported in the testis, ovary, lung, liver, and gastrointestinal tract. [1][2][3][4][5][6][7][8][9][10] Primary hepatic choriocarcinoma is particularly rare, with only 10 reported cases, [4][5][6][7][8][9] mostly from China and Japan. 5,6,8,9 We present a case of primary hepatic choriocarcinoma in an 83-year-old woman.…”