Choriocarcinoma with multiple lung, skull and skin metastases in a postmenopausal female: A case report

Gestational trophoblastic disease with a primary extra-uterine nidus is rare, particularly during the postmenopausal period. The present report outlines a case of high-risk choriocarcinoma (International Federation of Gynecology and Obstetrics stage IV; World Health Organization score 13) in a 68-year-old female exhibiting neoplasm. The choriocarcinoma developed 20 years subsequent to the onset of menopause and 42 years following the patient's final pregnancy, and was associated with multiple metastases to the lungs, skull, neck, lymph nodes and skin. The patient was administered two courses of systemic chemotherapy with tegafur (800 mg) and actinomycin D (200 µg). Local chemotherapy was also administered to the scalp and left flank masses; the masses were injected first with methotrexate, and then with 5-fluorouracil. During chemotherapy, the patient's levels of β-human chorionic gonadotrophin (β-HCG) decreased from 3,171 IU/l to 1,763 IU/l, however by the conclusion of the courses of systemic and local chemotherapy, β-HCG levels had increased to 3,704 IU/l. The patient and their family subsequently elected to end treatment. The patient subsequently succumbed to infection, tumor consumption and organ insufficiency. This study describes the clinical and radiological features, as well as the treatment used for this rare type of choriocarcinoma.