Uterine choriocarcinoma: A gynaecological masquerader case report and review of the literature

Abstract

Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy. She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. Conclusion: The diagnosis of choriocarcinoma may be difficult especially when it develops ab initio without preceding abortion, molar or term pregnancy. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring.

Share and Cite:

Kelech, E. , Umezurike, C. and Akwuruoha, E. (2013) Uterine choriocarcinoma: A gynaecological masquerader case report and review of the literature. Modern Chemotherapy, 2, 69-72. doi: 10.4236/mc.2013.24009.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] James, F.H., et al. (1993) Cancer medicine. 3rd Ed, Lea & Febinger, Philadelphia, 704, 1691-1694.
[2] Muggia, F.M., Eifel, P.J. and Burke, T.W. (1997) Gestational trophoblastic diseases. In: de Vita Jr., V.J., Hellman, S. and Rosenberg, S.A., Eds., Cancer Principles and Practice of Oncology, Lippincott-Raven, Philadelphia, 1427-1539.
[3] Royal College of Obstetricians and Gynaecologists (2010) The management of gestational trophoblastic disease. RCOG, London.
[4] Ng, T.Y. and Wong, L.C. (2003) Diagnosis and management of gestational trophoblastic neoplasia. Best Practice & Research Clinical Obstetrics and Gynaecology, 17, 893-903.
http://dx.doi.org/10.1016/S1521-6934(03)00098-1
[5] Paradinas, F.J. (1992) Pathology and classification of trophoblastic tumours. In: Coppleson, M., Ed., Gynaecologic Oncology, 2nd Edition, Churchill Livingstone, London, 1013-1026.
[6] Acosta-Sison, H. (1959) Ab initio choriocarcinoma: Two unusual cases. Obstetrics & Gynecology (New York), 13, 350-352.
[7] Seckl, M.J., Sabire, N.J. and Berkowitz, R.S. (2010) Gestational trophoblastic disease. The Lancet, 376, 717-729.
http://dx.doi.org/10.1016/S0140-6736(10)60280-2
[8] Fox, H. and Buckley, C.H. (1992) The female genital tract and ovaries. In: McGee, J.O.D., Isaacson, P.G. and Wright, N.A., Eds., Oxford Text Book of Pathology, 2nd Edition, Oxford University Press, New York, 1565-1639.
[9] Balagopal, P.G., et al. (2003) Unusual presentation of choriocarcinoma. World Journal of Surgical Oncology, 2003, 1, 4. http://dx.doi.org/10.1186/1477-7819-1-4
[10] McNeish, I.A., et al. (2002) Low-risk persistent gestational trophoblastic disease: Outcome after initial treatment with low-dose methotrexate and folinic acid from 1992 to 2000. Journal of Clinical Oncology, 20, 1838-1844. http://dx.doi.org/10.1200/JCO.2002.07.166
[11] Rustin, G.J.S., Newlands, E.S., Lutz, J.M., et al. (1996) Combination but not single-agent Methotrexate chemotherapy for gestational trophoblastic tumors increases the incidence of second tumors. Journal of Clinical Oncology, 14, 2769-2773.
[12] Bower, M., Rustin, G.J.S., Newlands, E.S., et al. (1998) Chemotherapy for gestational trophoblastic tumours hastens menopause by 3 years. European Journal of Cancer, 34, 1204-1207.
http://dx.doi.org/10.1016/S0959-8049(98)00059-8

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.