Ovarian ectopic pregnancy misdiagnosed as gestational choriocarcinoma: A case report

Kazemi, Seyyedeh Neda; Raoufi, Masoomeh; Moghaddam, Noushin Afshar; Tabatabaeefar, Morteza; Ganjooei, Tahereh Ashraf

doi:10.1016/j.amsu.2021.103236

Cited by 10 publications

(9 citation statements)

References 18 publications

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“…The suggestion that ovarian pregnancies are associated with more blood loss than tubal pregnancies could not be confirmed (2,3,13,18). Occasionally an ovarian pregnancy can result in a choriocarcinoma (43).…”

Section: Main Findingsmentioning

confidence: 99%

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

Almahloul¹,

Amro²,

Nagshabandi³

et al. 2022

Preprint

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Objective Ovarian pregnancy is a rare but well-known pathology. However, pathophysiology, diagnosis and treatment are not clearly established. Data sources. All case reports published in Pubmed from Nov 2011 till Nov 2022. Study eligibility criteria. A systematic review and 2 case reports of ovarian pregnancy Study appraisal and synthesis methods. Not applicable Results Ovarian pregnancies occur in 8% of women without or blocked oviducts and in 23% on the other side than the corpus luteum and the symptoms of ovarian pregnancies are not specific. Therefore ovarian pregnancy has to be suspected in all women with abdominal bleeding. As for extrauterine pregnancies, the presence of an intrauterine pregnancy does not rule out an ovarian pregnancy. Surgical excision is the preferred treatment. Important is that in women with both an intra-uterine and an ovarian pregnancy, care should be taken not to damage the corpus luteum. Conclusions Ovarian pregnancies can occur in women with blocked tubes, on the other side of the corpus luteum, in the presence of an intrauterine pregnancy, and even when pregnancy tests or tranvaginal ultrasonography are negative. The diagnosis being difficult to exclude, a laparoscopy is indicated in all women with intra-abdominal bleeding, keeping in mind that an intra-uterine pregnancy cannot be exluded and that a corpus luteum need to be respected.

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Section: Main Findingsmentioning

confidence: 99%

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

Almahloul¹,

Amro²,

Nagshabandi³

et al. 2022

Preprint

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“…Puede originarse por cualquier tipo de embarazo: el 50% surge después de un mola hidatiforme, el 25% después de un aborto espontáneo, el 22,5% después de un embarazo normal y el 2,5% después de un embarazo ectópico. A su vez, puede desarrollarse tan pronto como 5 semanas después de la gestación previa, hasta 15 años después de la gestación, e incluso, después de la menopausia (8)(9)(10). Por su parte, los coriocarcinomas no gestacionales de ovario corresponden a menos del 0,6% de los tumores de células germinales de ovario y se presentan principalmente en niñas y adultas jóvenes, con una edad promedio de diagnóstico de 13,6 años ± 6,9 años.…”

Section: Epidemiologíaunclassified

“…Dentro de los hallazgos ultrasonográficos se puede encontrar una gran masa heterogénea e hipervascular de origen ovárico (9,18).…”

Section: Estudio De Imágenesunclassified

Coriocarcinoma gestacional y no gestacional del ovario

Garbanzo

Gutiérrez

2022

Rev.méd.sinerg.

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El coriocarcinoma de ovario es un tumor de células germinales con una incidencia muy baja y que puede ser de tipo gestacional o no gestacional, dependiendo de su etiología. Las pacientes cursan con síntomas muy variados, desde dolor abdominal, sangrado uterino anormal, hasta efectos secundarios causados por la elevación de hCG o producto de las metástasis frecuentemente en pulmón y cerebro. Su diagnóstico es muy difícil y tiende a confundirse con otras patologías ováricas. Generalmente, se necesita ultrasonido, estudios patológicos y genéticos para realizar un diagnóstico acertado. El tratamiento consiste en ciclos de quimioterapia y manejo quirúrgico. La sobrevida depende del estadio al momento del diagnóstico.

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“…The onset of choriocarcinomas may range from 5 weeks to 5 years after gestation or even after menopause. 6 A tubal choriocarcinoma may be misdiagnosed with an ectopic pregnancy since both share similar symptoms, including vaginal bleeding, amenorrhea, elevated beta-human chorionic gonadotropin (BHCG) levels, and pelvic pain. 7 Herein, the authors present a rare case of choriocarcinoma in the fallopian tube, for which salpingectomy and chemotherapy were applied as treatment, after which no evidence of recurrence was observed a year after the final chemotherapy session.…”

Section: Introductionmentioning

confidence: 99%

Choriocarcinoma in tubal pregnancy: A case report

Najib,

Bahrami,

Shiravani

et al. 2023

Clinical Case Reports

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Key Clinical MessageChoriocarcinoma of the fallopian tube is extremely rare and highly susceptible to early metastasis. Clinical manifestations of ectopic pregnancy and choriocarcinoma are the same, and all patients with ectopic pregnancy should be evaluated for choriocarcinoma based on histopathological findings. Adjuvant chemotherapy (after surgery) is the proposed treatment for tubal choriocarcinoma.AbstractChoriocarcinoma is a malignant epithelial tumor of the chorionic villi that often manifests after a normal or molar pregnancy. The primary tubal choriocarcinoma associated with ectopic pregnancy is extremely rare and can be misdiagnosed as an ectopic pregnancy since symptoms including vaginal bleeding, amenorrhea, elevated beta‐human chorionic gonadotropin (BHCG) levels, and pelvic pain are shared. A 34‐year‐old G4P3003 woman presented with a one‐week history of vaginal bleeding and right lower abdominal pain, which had intensified a day before admission. Clinical and paraclinical examinations pointed to a ruptured tubal pregnancy; hence, an emergency laparotomy was performed, and a right salpingectomy was carried out on the patient. However, a nonsignificant decline in BHCG level was observed, and histological examination revealed tubal choriocarcinoma; hence, a metastasis workup was carried out, yet no metastasis was detected. Six sessions of chemotherapy consisting of Etoposide, Methotrexate, Dactinomycin, Cyclophosphamide, and Vincristine (EMA‐CO) were administered without complication, in such a way that the BHCG level normalized after three sessions of chemotherapy. Evaluations after 1 year from the completion of chemotherapy revealed that the patient had no subsequent problems. Choriocarcinoma of the fallopian tube is extremely rare and highly susceptible to early metastasis. Clinical manifestations of ectopic pregnancy and choriocarcinoma are the same, and all patients with ectopic pregnancy should be evaluated for choriocarcinoma based on histopathological findings. Metastasis workup should be considered for all individuals with choriocarcinoma. Adjuvant chemotherapy (after surgery) is the proposed treatment for tubal choriocarcinoma.

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Ovarian ectopic pregnancy misdiagnosed as gestational choriocarcinoma: A case report

Cited by 10 publications

References 18 publications

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

Coriocarcinoma gestacional y no gestacional del ovario

Choriocarcinoma in tubal pregnancy: A case report

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