Choriocarcinoma presenting following a molar pregnancy and preterm vaginal delivery: rarest of rare case
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20210343Keywords:
Choriocarcinoma, Molar pregnancy, Preterm vaginal deliveryAbstract
Choriocarcinoma is the aggressive histologic type of GTN and is characterized by vascular invasion and metastases of widespread. Choriocarcinoma metastasizes hematogenously. Suction and evacuation were done on admission. Beta-hCG was 67900 mIU/ml and 144523 mIU/ml on day 1 and day 3 respectively and histopathology showed Choriocarcinoma. This is very unusual case of reviewing sequential events. It was difficult to detect is it new pregnancy or choriocarcinoma. Investigators were biased with high beta-hCG values indicating malignancy. So there was differential diagnosis as choriocarcinoma based on history of molar pregnancy and increasing beta-hCG value and also dictum of 'non molar pregnancy following live birth is always choriocarcinoma. However histopathology report suggested choriocarcinoma and was diagnostic.
References
Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet 2010;376:717.
Feltmate CM, Genest DR, Wise L. Placental site trophoblastic tumor: a 17-year experience at the New England trophoblastic disease center. Gynecol Oncol. 2001;82:415.
Bagshawe KD, Dent J, Webb J. Hydatidiform mole in England and Wales in 1973–1983. Lancet. 1986;2(8508):673-7.
Green top guideline No 38 management of gestational trophoblastic Neoplasia. Available at: http://www.rcog.org.uk/files/rcog-corp/GT38 ManagementGestational0210.pdf. Accessed on 20 July 2020.
Fowler DJ, Lindsay I, Seckl MJ. Routine pre-evacuation ultrasound diagnosis of hydatidiform mole: experience of more than 1000 cases from a regional referral center. Ultrasound Obstet Gynecol. 2006;27:56-60.
Dobson LS, Gillespie AM, Coleman RE. The presentation and management of post-partum choriocarcinoma. Br J Cancer. 1999;79:1531-3.
Management of early pregnancy loss. Green-top guideline No. 25. Available at: www.rcog.org.uk/ womenshealth/clinical-guidance/management-early-pregnancy-loss-green-top-25. Accessed on 20 July 2020.
Powles T, Young A, Sammit A. The significance of the time interval between antecedent pregnancy and diagnosis of high risk gestational trophoblastic tumours. Br J Cancer. 2006;95:1145-7.
Ma Y, Xiang Y, Wan XR. The prognostic analysis of 123 post partum choriocarcinoma cases. Int J Gynecol Cancer. 2008;18:1097-101.
