Gestational Choriocarcinoma Presenting with Lacrimal Gland Metastasis: A First Reported Case

Abstract

Background. Gestational choriocarcinoma (GC) is a recognized clinicopathological subtype of gestational trophoblastic neoplasia that usually metastasizes hematogenously to highly vascular organs like the lung, liver, and brain. However, orbital metastasis to the choroid and lacrimal gland is a rare occurrence. Case Presentation. A 21-year-old female presented with headache and left orbital swelling one year after resection of a complete hydatidiform mole followed by adjuvant methotrexate chemotherapy. A metastatic imaging screening revealed multiple metastases in the lungs, brain, and adrenal gland, in addition to the choroid and lacrimal gland. Based on her modified WHO risk factors scoring she was started on chemotherapy and whole brain radiotherapy, which resulted in a complete response. At two-year follow-up, serum b-HCG level was with normal limits; imaging surveillance was uneventful. Conclusion. We present the first case of lacrimal gland metastasis in a young girl from GC relapse.

A Successfully Treated Multiple Metastatic Choriocarcinoma Coexistent With Live Fetus: A Case Report and Literature Review

“…Metastases tend to occur in the lungs, causing respiratory symptoms like cough, hemoptysis, and dyspnea. Metastases occur less frequently in the brain, presenting neurological symptoms like headaches, sensory disturbance, rarely in the vagina, pelvis, liver, and lymph nodes (21)(22)(23). The patient in our study was admitted because of mild vaginal bleeding during the second trimester, and the pathological findings of vaginal mass confirmed the diagnosis of choriocarcinoma.…”

Accurate short tandem repeat analysis for confirmation of rare gestational adrenal choriocarcinoma: a case report

“…Second is the ultrasound of the pelvic cavity ( 8 - 11 ). If any mass is found in both pelvic cavity and extragonadal area in the ultrasound, the diagnosis is likely to be secondary choriocarcinoma ( 9 ). However, these methods mislead doctors sometimes because both of the detections can’t give an accurate diagnosis, which could lead to false treatment ( 6 , 7 , 12 ).…”

Metastatic Osteosarcoma of Lacrimal Gland

“…The common primary tumours metastasizing to the lacrimal gland include breast, oesophagus, thyroid, carcinoid ileum and mediastinum. 1 There have been two case reports of gestational choriocarcinoma and hepatocellular carcinoma presenting with lacrimal gland metastasis. 1,2 Single bone metastasis from adenocarcinoma of lacrimal gland has been reported.…”

“…1 There have been two case reports of gestational choriocarcinoma and hepatocellular carcinoma presenting with lacrimal gland metastasis. 1,2 Single bone metastasis from adenocarcinoma of lacrimal gland has been reported. 3 Also metastasis of osteosarcoma to the orbit is known.…”