Splenic Metastatic Choriocarcinoma with Nontraumatic Splenic Rupture: A Case Report and Literature Review

Abstract

Choriocarcinoma is a highly malignant trophoblastic tumor that occurs mostly in women of childbearing age. The main mode of metastasis is hematogenous metastasis. The most common sites of metastasis are the lung, vagina and brain, while splenic metastasis is rare. Because of its rapid development, extensive metastasis can occur in a short period, and some patients only show metastatic symptoms, which are often missed or misdiagnosed as ectopic pregnancy or other diseases. We describe a rare case of splenic metastatic choriocarcinoma with acute abdominal pain caused by nontraumatic splenic rupture. In addition, we review the previous literature on splenic metastasis of choriocarcinoma and summarize the clinical manifestations, management measures and prognoses. Our case and literature review indicate that splenic metastatic choriocarcinoma is rare and difficult to distinguish from splenic ectopic pregnancy and other diseases. Clinicians should strengthen their understanding of this disease and avoid misdiagnosis.

Retroperitoneal Hematoma as an Atypical Presentation of Choriocarcinoma: A Case Report

“…The typical initial presentations include vaginal bleeding, irregular sized uterus, beta-hCG >100,000 mIU/mL, and multiple echoes or focal cystic spaces noted on ultrasound [ 1 ]. The most common sites of metastases in GTN include the lungs, brain, and vagina [ 2 ]. GTN can be fatal due to distant and rapidly growing metastases to the brain with intracranial hemorrhage or abdominal bleeding from uterine rupture [ 1 ].…”

“…GTN can be fatal due to distant and rapidly growing metastases to the brain with intracranial hemorrhage or abdominal bleeding from uterine rupture [ 1 ]. There are only a few rare case reports describing metastases to the spleen or to the kidneys [ 2 – 5 ]. In this report, we highlight the unusual case of a woman who presented with spontaneous massive retroperitoneal hematoma caused by GTN.…”