Intestinal choriocarcinoma without primary source: A diagnostic enigma

Intestinal choriocarcinoma is a very rare phenomenon. This is the first reported case of intestinal choriocarcinoma following an ectopic pregnancy. We report a 24 year-old woman who presented with severe abdominal pain, distension, and vomiting. She had a history of an ectopic pregnancy nine months prior. Emergent laparotomy exploration revealed abscess formation and obstructions at two sites in the small intestine, with unremarkable gynecological organs. The obstructed sections of the intestinal were excised and subsequently diagnosed as intestinal choriocarcinoma in histopathological evaluation. Postoperative positron emission tomography (PET) revealed a non-contrast-enhancing lesion on the small intestinal wall with increased metabolic activity consistent with healing tissue at the anastomosis site. No other primary focus and/or metastatic lesions were detected. Multi-agent chemotherapy was planned for the patient. No residual and/or recurrent tumoral lesions were detected on the PET scan at the one-year follow-up.