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Primary abdominal gestational choriocarcinoma.
Jennifer L Bailey1, Emily A Hinton, Raheela Ashfaq
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Southwestern Trophoblastic Disease Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032, USA.
Obstetrics and Gynecology
|December 16, 2003
Summary
Primary abdominal gestational choriocarcinoma, a rare condition, was successfully treated with surgery and chemotherapy. This case highlights the importance of considering this diagnosis in patients presenting with symptoms mimicking a ruptured ectopic pregnancy.
Area of Science:
- Gynecologic Oncology
- Reproductive Endocrinology
- Surgical Pathology
Background:
- Gestational choriocarcinoma is a rare malignancy.
- Ectopic pregnancies are common, but association with choriocarcinoma is extremely infrequent.
- Primary abdominal gestational choriocarcinoma has not been previously documented.
Observation:
- A patient presented with vaginal spotting and a high serum human chorionic gonadotropin (hCG) level.
- Sonography revealed hemoperitoneum without an intrauterine pregnancy.
- A friable, bleeding mass was found on the anterior abdominal wall during laparoscopy.
Findings:
- Histopathologic review confirmed gestational choriocarcinoma.
- The tumor was staged as International Federation of Gynecology and Obstetrics (FIGO) stage IV:4.
- The patient achieved clinical remission following treatment.
Implications:
- Primary abdominal gestational choriocarcinoma can mimic a ruptured ectopic pregnancy.
- Surgical excision is a crucial treatment component.
- Combination chemotherapy is indicated for management and achieving remission.