Malignant trophoblastic tumors with massive hemorrhage presenting as liver primary. A report of two cases

Two women, aged 29 and 27, presented with evidence of recent hemorrhage and large tumors of the liver. One tumor was successfully resected; the other patient died of blood loss. Both lesions were almost identical and were indistinguishable from choriocarcinoma. Both patients had markedly elevated serum human chorionic gonadotropin (hCG) levels and positive pregnancy tests. Examination of the endometrium showed only proliferative endometrium, and the pelvic organs were found to be normal. Immunoperoxidase stains of the liver tumors were strongly positive for hCG and human placental lactogen. Alpha-1-antitrypsin and alpha-fetoprotein tests were weakly positive, and one patient tested positive for carcinoembryonic antigen.