Jennifer L Bailey1, Emily A Hinton, Raheela Ashfaq, John O Schorge. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Southwestern Trophoblastic Disease Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032, USA.
Abstract
BACKGROUND: Gestational choriocarcinoma associated with ectopic pregnancy is an extremely infrequent event. Primary abdominal gestational choriocarcinoma has not been previously described. CASE: A pregnant woman presented to the emergency room with 6 days of vaginal spotting. Her last menstrual period suggested a gestation at 6 4/7 weeks. Transvaginal sonogram showed a hemoperitoneum with no intrauterine pregnancy. The serum human chorionic gonadotropin level was noted to be 317,735 mIU/mL. A 20 x 20-mm friable, bleeding mass on the left anterior abdominal wall was laparoscopically resected. Gestational choriocarcinoma was identified on histopathologic review. International Federation of Gynecology and Obstetrics stage IV:4 was assigned, and the patient achieved clinical remission with combination chemotherapy. CONCLUSION: Primary abdominal gestational choriocarcinoma can present with findings similar to a ruptured ectopic pregnancy; it should be treated by surgical excision and chemotherapy.
BACKGROUND:Gestational choriocarcinoma associated with ectopic pregnancy is an extremely infrequent event. Primary abdominal gestational choriocarcinoma has not been previously described. CASE: A pregnant woman presented to the emergency room with 6 days of vaginal spotting. Her last menstrual period suggested a gestation at 6 4/7 weeks. Transvaginal sonogram showed a hemoperitoneum with no intrauterine pregnancy. The serum human chorionic gonadotropin level was noted to be 317,735 mIU/mL. A 20 x 20-mm friable, bleeding mass on the left anterior abdominal wall was laparoscopically resected. Gestational choriocarcinoma was identified on histopathologic review. International Federation of Gynecology and Obstetrics stage IV:4 was assigned, and the patient achieved clinical remission with combination chemotherapy. CONCLUSION:Primary abdominal gestational choriocarcinoma can present with findings similar to a ruptured ectopic pregnancy; it should be treated by surgical excision and chemotherapy.