Primary non‐gestational uterine choriocarcinoma mimicking leiomyoma

Abstract

Uterine choriocarcinoma is a trophoblastic neoplasm that is most commonly gestational but can also be non‐gestational in origin. However, primary non‐gestational uterine choriocarcinoma is very rare, with only few cases having been reported. We report a case of a premenopausal woman who had initially been diagnosed with myoma delivery but who was discovered to have primary non‐gestational uterine choriocarcinoma. This 46‐year‐old woman had no history of pregnancy. She was referred to our hospital for treatment of the myoma delivery. After tumor removal, histological examination led to the diagnosis of choriocarcinoma. The serum human chorionic gonadotropin level (207,300 mIU/mL) prior to surgery was abnormally high, and because the computed tomography scans additionally revealed lung metastasis, the patient was diagnosed with FIGO stage III choriocarcinoma. Due to the lack of pregnancy history and abstinence from sexual intercourse for >1 year, we performed short tandem repeat analysis, and diagnosed the patient with non‐gestational choriocarcinoma. Despite treatments using multiple anticancer agents after the surgery, the patient died 1 year after starting the treatments. On this occasion, we report a very rare case of a premenopausal woman who was diagnosed with primary non‐gestational uterine choriocarcinoma mimicking leiomayoma.

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

“…Because the treatment and prognosis of primary and secondary choriocarcinoma differ, to distinguish these two types of carcinoma is necessary ( 1 - 6 ). Based on the review of related literatures, a series of measures were concluded for accurate diagnoses of primary choriocarcinoma.…”

“…There are two types of choriocarcinoma, gestational (secondary) choriocarcinoma (GC) and nongestational (primary) choriocarcinoma (NGC). It is important for clinicians to distinguish between these two types of tumor because of their different treatment and prognosis ( 1 - 6 ). Up till now, most of the literatures have mainly used two methods for auxiliary diagnosis.…”

“…The patient will be suspected with primary choriocarcinoma if the time period is more than 3 years ( 7 ). The diagnosis will be confirmed if the patient has menopause or is nulliparous ( 4 , 6 ). 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 ). According to what we have studied, some researchers used STR as a method to identify nongestational choriocarcinoma ( 5 , 6 , 13 , 14 ).…”

“…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 ). According to what we have studied, some researchers used STR as a method to identify nongestational choriocarcinoma ( 5 , 6 , 13 , 14 ). However, they are all about choriocarcinoma in genital system.…”