Gestational choriocarcinoma with renal and pulmonary metastases lacking a primary uterine origin

Li, Haoming; Hou, Wen-Chien; Lai, Yu-Ju; Kao, Chung-Cheng; Chao, Tai-Kuang; Yu, Mu-Hsien; Su, Her-Young

doi:10.1016/j.tjog.2015.08.028

Cited by 13 publications

(6 citation statements)

References 9 publications

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“…Gestational choriocarcinoma is the most aggressive form of gestational trophoblastic neoplasia due to its local invasiveness and marked tendency to metastasize, but it is generally responsive to chemotherapy. Most of the time occurs in the uterus but in some patients it can manifest as disseminated disease, without a clearly detectable uterine mass [4 – 6] . According to some hypothesis of literature, these forms may represent metastases from undetected trophoblastic disease, which might undergo a spontaneous regression merely leaving scarring of the uterus.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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Gestational choriocarcinoma is a malignant trophoblastic tumor arising from any gestational event, even with a long latency period, generally in the reproductive female. It is associated with a high level of beta-human chorionic gonadotropin. Its primary site is usually the uterus but not all patients have a detectable lesion in this site. Regression of the primary tumor after it has metastasized is not uncommon, and one-third of cases manifest as complications of metastatic disease. In this report we present an uncommon case of gestational choriocarcinoma with lung, liver and jejunal metastases at the time of diagnosis without evidence of pelvic disease, in 34-year-old woman. The main points of interest of our case were the development of the ovarian hyperstimulation syndrome with massive multicystic ovarian enlargement induced by high level of beta-human chorionic gonadotropin and the bleeding of jejunal and liver metastases, due to the high vascularity of the tumor tissue, a condition known as “Choriocarcinoma Syndrome”. We will focus on the radiological findings of metastases, bleeding complications and ovarian hyperstimulation syndrome.

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Section: Discussionmentioning

confidence: 99%

“…It usually originates from the uterus, sometimes without a clearly detectable lesion. Regression of the primary tumor after it has metastasized is not uncommon and one-third of cases manifest with complications of metastatic disease [ [4] , [5] – 6] .…”

Section: Introductionmentioning

confidence: 99%

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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“…Case similar to ours with unknown primary with kidney and lung metastases has been mentioned in literature. 3 …”

Section: Discussionmentioning

confidence: 99%

Gestational choriocarcinoma presenting with bilateral kidney and lung metastases with unknown primary: An uncommon clinical scenario

Parajuli

Poudyal

Chapagain

et al. 2020

Urology Case Reports

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“…Indeed, gestational choriocarcinoma without uterine lesions on initial presentation is very rare (11). However, one paper reported a case of gestational choriocarcinoma (con rmed by DNA analysis) with renal and pulmonary metastases without any uterine lesions (12). This may be due to spontaneous regression of the uterine tumor, possibly because gestational choriocarcinoma is a tissue allograft for the patient that induces strong immune reactions from the patient.…”

Section: Discussionmentioning

confidence: 99%

A Poor Prognostic Metastatic Nongestational Choriocarcinoma of the Ovary: A Case Report and the Literature Review.

Nishino

Yamamoto

Ikeda

et al. 2020

Preprint

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Background: Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. Case presentation: A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma.Conclusion: Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

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Gestational choriocarcinoma with renal and pulmonary metastases lacking a primary uterine origin

Abstract: In women of reproductive age, unexplained hematuria should raise concerns about possible choriocarcinoma, either metastatic gestational or primary nongestational choriocarcinoma of the kidney.

Cited by 13 publications

References 9 publications

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Gestational choriocarcinoma presenting with bilateral kidney and lung metastases with unknown primary: An uncommon clinical scenario

A Poor Prognostic Metastatic Nongestational Choriocarcinoma of the Ovary: A Case Report and the Literature Review.

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