Choriocarcinoma following scar pregnancy: a case report

Abstract

Choriocarcinoma following scar pregnancy is a very rare entity. Here we present such a unique case. The index pregnancy was a sterilization failure which developed in the scar of previous caesarean. The scar pregnancy was evacuated through a hysterotomy incision and she was re sterilized. The histopathology report of the evacuated products showed normal villi. Two and a half months later she presented with bleeding per vaginum. Her beta HCG was raised and she had a vascular mass in the lower uterine myometrium. Gestational trophoblastic neoplasia was suspected and three courses of methotrexate folinic acid regime were administered. But the fall in beta HCG was inappropriate. She had no desire for future fertility and was not willing for combination chemo therapy. So hysterectomy was done. Histopathology revealed choriocarcinoma. Chest x-ray was apparently normal but CT chest showed micro metastasis. She had three courses of EMA-CO and is under follow up. She is asymptomatic and her beta HCG is less than 5 IU/l.