Choriocarcinoma-presenting as a primary lesion of the cervix

A 25 year old nulliparous Russian lady presented to the hospital complaining of abdominal pain and mild vaginal bleeding. In 1999 she was diagnosed with a molar gestation and required a dilatation and curettage. On this occasion, Beta human Chorionic Gonadotrophin (BhCG) levels were elevated and a trans-vaginal ultrasound scan suggested the presence of a left-sided pelvic mass. Investigations confirmed the presence of a choriocarcinoma of the cervix. Complete assessment by a multidisciplinary team was performed and chemotherapy (methotrexate) was commenced. This case of a twenty-five year old nulliparous woman highlights the importance of appropriate follow-up in cases of irregular genital tract bleeding with a past history of trophoblastic disease.