A Case of Postpartum Choriocarcinoma: Delay in Diagnosis and Lessons Learnt

Riyami, Nihal Al; Gowri, Vaidyanathan; Kakaria, Anupam K.; Lakhtakia, Ritu

doi:10.1007/s13224-013-0444-9

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…Our patient underwent MRI to rule out choriocarcinoma (although beta HCG was low), and also to evaluate the local extrauterine extension of the mass. Postpartum choriocarcinoma is a very rare complication of pregnancy [31]. The correct diagnosis is only made with pathological examination and the prognosis for women with choriocarcinoma after non-molar pregnancies is worse, due to delay in diagnosis or advanced disease [31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Postpartum choriocarcinoma is a very rare complication of pregnancy [31]. The correct diagnosis is only made with pathological examination and the prognosis for women with choriocarcinoma after non-molar pregnancies is worse, due to delay in diagnosis or advanced disease [31,32]. The differential diagnosis of placenta increta must also consider placental site trophoblastic tumor, epithelioid trophoblastic tumor, exaggerated placental site, and atypical placental site nodule [31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

“…The correct diagnosis is only made with pathological examination and the prognosis for women with choriocarcinoma after non-molar pregnancies is worse, due to delay in diagnosis or advanced disease [31,32]. The differential diagnosis of placenta increta must also consider placental site trophoblastic tumor, epithelioid trophoblastic tumor, exaggerated placental site, and atypical placental site nodule [31][32][33][34][35]. Placental site trophoblastic tumor is a rare form of gestational trophoblastic disease and represents a malignant transformation of intermediate trophoblastic cells.…”

Section: Discussionmentioning

confidence: 99%

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Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

Tîrnovanu,

Toma

et al. 2023

JPM

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Placental morbid adherence is a known risk factor for postpartum hemorrhage. The incidence of abnormal placental attachment has been increasing over the past few decades, mainly due to rising rates of cesarean deliveries, advanced maternal age, and the use of assisted reproductive technologies. Cesarean section is a significant risk factor for placenta increta, as it disrupts the normal architecture of the uterine wall, making it more difficult for the placenta to detach after delivery. We present the case of a woman who underwent a cesarean section at 28 weeks due to anterior placenta previa, accompanied by hemorrhage and rupture of membranes. Following the delivery, she experienced normal postoperative bleeding and was discharged home after five days. However, six weeks later, she presented with heavy bleeding, leading to the decision to perform a total hysterectomy. The levels of HCG were found to be low. The pathological examination of the specimens confirmed a diagnosis of placenta increta, as it revealed notable placental proliferation, necrotic villi, and placental invasion near the uterine serosa. Notably, we did not find any similar cases documented in the literature. Patients experiencing prolonged vaginal bleeding after childbirth and diagnosed with placenta accreta should be closely monitored through ultrasound examinations; abnormal proliferation of the placenta can occur, and prompt detection is crucial for appropriate management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

Tîrnovanu,

Toma

et al. 2023

JPM

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“…Hence, the bad prognosis associated with term choriocarcinoma may be explained by other factors, such as the increased delay in the diagnosis of a post-term choriocarcinoma compared to postmolar choriocarcinoma. Indeed, postmolar surveillance (i.e., weekly serum hCG) is much more intense than the surveillance following term delivery, where patients usually do not undergo routine hCG monitoring [17][18][19]. Also, according to the FIGO score, post-term choriocarcinoma are diagnosed at stages much more advanced than postmolar choriocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Transcriptomic Characterization of Postmolar Gestational Choriocarcinoma

et al. 2021

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The human placenta shares properties with solid tumors, such as rapid growth, tissue invasion, cell migration, angiogenesis, and immune evasion. However, the mechanisms that drive the evolution from premalignant proliferative placental diseases—called hydatidiform moles—to their malignant counterparts, gestational choriocarcinoma, as well as the factors underlying the increased aggressiveness of choriocarcinoma arising after term delivery compared to those developing from hydatidiform moles, are unknown. Using a 730-gene panel covering 13 cancer-associated canonical pathways, we compared the transcriptomic profiles of complete moles to those of postmolar choriocarcinoma samples and those of postmolar to post-term delivery choriocarcinoma. We identified 33 genes differentially expressed between complete moles and postmolar choriocarcinoma, which revealed TGF-β pathway dysregulation. We found the strong expression of SALL4, an upstream regulator of TGF-β, in postmolar choriocarcinoma, compared to moles, in which its expression was almost null. Finally, there were no differentially expressed genes between postmolar and post-term delivery choriocarcinoma samples. To conclude, the TGF-β pathway appears to be a crucial step in the progression of placental malignancies. Further studies should investigate the value of TGF- β family members as biomarkers and new therapeutic targets.

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A Case of Postpartum Choriocarcinoma: Delay in Diagnosis and Lessons Learnt

Cited by 2 publications

References 5 publications

Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

Unexpected Dramatic Evolution of Placenta Increta: Case Report and Literature Review

Transcriptomic Characterization of Postmolar Gestational Choriocarcinoma

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