Choriocarcinoma in the term placenta: a difficult diagnosis

Although choriocarcinoma following a term pregnancy is an uncommon disease, it is important to identify these patients early. The time interval between delivery and onset of treatment is a crucial factor influencing prognosis. We present a case where the woman was delivered of a stillborn infant and histological examination of the placenta at first did not reveal the true diagnosis of choriocarcinoma. Due to persistent vaginal bleeding curettage was performed 11 weeks later establishing choriocarcinoma. In this particular case it was then possible to review the original material and to confirm the diagnosis in this specimen. The case is extraordinary since the placenta harbouring the primary tumour had been macroscopically and microscopically described and the material could be reviewed. Secondly the case underlines the diagnostic difficulties when examining a mature placenta.