Massive Gastrointestinal Bleeding from Choriocarcinoma of the Ovary

Kumar, Shiyam; Raouf, Zaid R.; Saparamadu, P.A.M.; Burney, Ikram A.

doi:10.5001/omj.2018.96

Cited by 3 publications

(8 citation statements)

References 10 publications

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“…The symptoms of NGOC are vague and non-specific, and the age at presentation aligns with other beta-HCG producing conditions, including ectopic pregnancy. NGOC usually affects younger reproductive-aged woman and often presents with metastatic disease [22]. In the largest case review done by Lui et al, 39 case reports were reviewed with the peak age of onset ranging 12 to 25 years [13].…”

Section: Presentation and Diagnosismentioning

confidence: 99%

“…In the largest case review done by Lui et al, 39 case reports were reviewed with the peak age of onset ranging 12 to 25 years [13]. The most common signs and symptoms are vaginal bleeding, abdominal pain, adnexal mass on ultrasound, and a positive pregnancy test [6,11,13,14,22]. In children, initial presentation may also include precocious puberty [23].…”

Section: Presentation and Diagnosismentioning

confidence: 99%

“…The vascularity is due to the trophoblastic cells' innate capacity to invade and erode vascular structures [13]. Bleeding is the most often reported presentation of NGOC [30], including non-gynecologic bleeding such as profound hematochezia in a patient who had metastatic disease involving the intestines [22]. As a result, patients often have severe anemia requiring multiple blood transfusions or massive transfusion protocols [22,31].…”

Section: Clinicalmentioning

confidence: 99%

“…Bleeding is the most often reported presentation of NGOC [30], including non-gynecologic bleeding such as profound hematochezia in a patient who had metastatic disease involving the intestines [22]. As a result, patients often have severe anemia requiring multiple blood transfusions or massive transfusion protocols [22,31]. In one case report, a patient received 19 blood transfusions in the year prior to her diagnosis [3].…”

Section: Clinicalmentioning

confidence: 99%

“…In the largest chart review of 39 patients with NGOC, 80% of patients had metastatic disease to the lungs, 30% to the pelvis, 20% to the vagina, and 10% to the liver [13,46]. Other sites with less common metastatic disease included the gastrointestinal tract, spleen, and kidney [3,4,13,16,22]. Cerebral metastases have also been identified and one case report also described delayed diagnosis of brain metastases discovered two years after primary treatment [1,3].…”

Section: Stagingmentioning

confidence: 99%

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Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

et al. 2022

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Non-Gestational Ovarian Choriocarcinoma (NGOC) is an extremely rare ovarian tumor, with an incidence of less than 0.6% of malignant ovarian germ cell tumors. Its close pathologic resemblance to Gestational Ovarian Choriocarcinoma (GOC), however, requires special attention as the treatments differ greatly. NGOC typically affects patients in late adolescence or early reproductive years. As a result, NGOCs are often misdiagnosed as ectopic pregnancies due to their common presentation of bleeding, abdominal pain, adnexal mass, and positive serum beta-HCG. On pathologic examination, the tumor is indistinguishable from GOC, and only after review of tissue for paternal genetic components can the diagnosis of NGOC be made. Imaging studies often show highly vascular lesions with further investigation with computer topography (CT) sometimes showing metastatic lesions in the lungs, pelvis, vagina, and liver. These lesions are often hemorrhagic and can lead to catastrophic bleeding. Treatment is vastly different from GOC; NGOC requires treatment with both surgical resection and chemotherapy, with Bleomycin, Etoposide, and Cisplatin (BEP) being the most used regimen. With correct diagnosis and treatment, patients can often receive fertility sparing treatment with long term survival.

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Section: Presentation and Diagnosismentioning

confidence: 99%

Section: Presentation and Diagnosismentioning

confidence: 99%

Section: Clinicalmentioning

confidence: 99%

Section: Clinicalmentioning

confidence: 99%

Section: Stagingmentioning

confidence: 99%

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Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

et al. 2022

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A novel approach with concomitant laparoscopic uterine artery ligation and D&C as initial treatment for complicated gestational trophoblast disease in cesarean scar and cervical ectopic pregnancies

Lin

Kung

2021

Taiwanese Journal of Obstetrics and Gynecology

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Primary ovarian choriocarcinoma occurring in a postmenopausal woman: A case report

Dai¹,

Tang²,

Wang³

2023

World J Clin Cases

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BACKGROUND Nongestational ovarian choriocarcinoma (NGOC) is a rare but aggressive neoplasm with limited sensitivity to chemotherapy and a very poor prognosis. Few cases of NGOC have been reported, and there is limited information regarding its clinical features, treatment protocols, or prognosis. CASE SUMMARY A postmenopausal woman in her 5 th decade of life visited our clinic because of abnormal vaginal bleeding and an abdominal mass. Although she had been menopausal for more than eight years and her last abortion occurred nine years ago, she had an increased level of serum β-human chorionic gonadotropin (β-hCG). Thus, an ovarian neoplasm of trophoblastic origin was suspected, and exploratory laparotomy was performed. Based on the patient’s clinical history and the histopathological examination and immunohistochemistry results obtained postoperatively, we concluded that she most likely had primary NGOC. Cytoreductive surgery was performed in combination with adjuvant chemotherapy comprising bleomycin, etoposide, and cisplatin. Serum β-hCG levels decreased to normal after two cycles, and there was no evidence of recurrence after four cycles of chemotherapy. CONCLUSION Even in postmenopausal women, ovarian choriocarcinoma should be considered in the initial differential diagnosis for an adnexal mass.

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Massive Gastrointestinal Bleeding from Choriocarcinoma of the Ovary

Cited by 3 publications

References 10 publications

Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

Non-Gestational Ovarian Choriocarcinoma: A Rare Ovarian Cancer Subtype

A novel approach with concomitant laparoscopic uterine artery ligation and D&C as initial treatment for complicated gestational trophoblast disease in cesarean scar and cervical ectopic pregnancies

Primary ovarian choriocarcinoma occurring in a postmenopausal woman: A case report

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