A Rare Case of Gestational Choriocarcinoma with Lung and Vaginal Metastases with Obstructive Jaundice

Choriocarcinoma is a rare highly malignant neoplasm which may present with early metastases as it has a propensity of rapid haematogenous spread. However the neoplasm is chemosensitive and has a good prognosis even in advanced stages. We are presenting a case of a 26 years old female with early pregnancy presented with lung and vaginal metastases with obstructive jaundice. [International Federation of Gynaecology and Obstetrics (FIGO) stage III; World Health Organization score, 14]. Serum beta-hCG was 3,61,131 mIU/ml. Radiological evaluation suggested marked lung metastases with vaginal metastases. Patient was started on single agent chemotherapy doxorubicin in view of deranged liver function test. Patient was given 5 cycles of doxorubicin with liver function test and beta hcg monitoring. After liver function test normalized, patient was shifted to EMACO regimen for 6 cycles of treatment dose and 2 cycles of maintenance dose.