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Choriocarcinoma with diffuse intraabdominal abscess and disseminated intravascular coagulation. A case report
Angel Chao1, Chen-Tao Lin, Ting-Chang Chang
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Department of Anatomic Pathology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.
Background:
Management of choriocarcinoma complicated by diffused intraabdominal abscess is difficult, especially when disseminated intravascular coagulation (DIC) ensues.
Case:
A 29-year-old woman presented with massive vaginal bleeding, fever and severe abdominal pain. Choriocarcinoma with pulmonary and vaginal metastases was diagnosed along with diffused intraabdominal abscess. Hysterectomy and hypogastric artery ligation were performed after the fever and abdominal symptoms failed to respond to intravenous antibiotics. Although the patient developed DIC after surgery, transfusion, antibiotics and immediate combination chemotherapy improved her condition and controlled the malignancy. She was free of disease for > 20 months after treatment.
Conclusion:
Timely surgery, aggressive antibiotics and immediate postoperative chemotherapy are recommended for patients with choriocarcinoma complicated by intraabdominal abscess and DIC.