Uterine choriocarcinoma diagnosed 11 years after menopause: A case report

Abstract

BackgroundGestational trophoblastic neoplasms (GTNs) encompass a wide spectrum of diseases, of which choriocarcinoma is one of the most common. Choriocarcinoma occurs mainly in relation to pregnancy and rarely after the menopause. It has the potential to metastasize to organs other than the uterus.Case ReportWe describe a 62-year-old woman who presented with postmenopausal bleeding 11 years after the menopause. Pelvic ultrasound and abdominal/pelvic computerized tomography showed an intrauterine mass. Choriocarcinoma was diagnosed by Pipelle endometrial biopsy with positive staining for beta-human chorionic gonadotropin (hCG) and KI 67 along with an elevated serum beta-hCG level. The tumor was managed with multiple cycles of multidrug chemotherapy and follow-up based on serum beta-hCG levels according to the guidelines of the International Federation of Gynecology and Obstetrics (FIGO).ConclusionThis case report highlights that choriocarcinoma, a tumor normally associated with pregnancy, can present after the menopause.

Gestational choriocarcinoma in a postmenopausal woman. A case report and literature review

“…Concerning the frequency of appearance, the choriocarcinoma is in the majority of cases gestational, primarily intrauterine located, in cases of extrauterine gestational arising at position of ectopic pregnancy and in cases of non gestational possibly derived from pluripotent germ cells mostly in the ovaries high malignant variant. Primary non gestational choriocarcinoma derives from ovary germ cell tumors, residual germ cells or dedifferentiation of endometroid adenocarcinoma and referred mainly to anatomical locations in ovaries and rarely in uterus in postmenopausal period [25][26][27][28].…”

“…The Choriocarcinomas, which are highly vascular neoplasms have as main clinical presentation abnormal uterine bleeding and matestasize readily in approximately 30% of cases at the time of the final diagnosis and most commonly in lung 60-75%, vagina 40-50%, brain 15-20%, liver 15-20%, spleen 10%, intestines 10% (5% bowel metastasis), and central nervous system involvement in 10% of cases, very rare manifestation, 4% in cardiac intracavity mass, cardiac metastasis. Approximately 0.76-4% of choriocarcinomas referred to occur in ectopic anatomic locations and they are associated with more aggressive character with distant metastasis [25][26][27][28][29][30][31].…”

“…Additionally, to these references there were following complications and metastasis locations, specifically: Hcg influence in the thyreotropic action to thyreotoxis based on similar molecular structure Hcg and TSH thyroid stimulating hormone. Hypercoagulability (increasing the activation of platelets, factor XII, X, cytokines TNFa, IL-1,IL-6) [25][26][27][28][29][30][31].…”

Penyakit Trofoblas Ganas Pada Wanita Usia 50 Tahun : Sebuah Laporan Kasus

“…Iagnosis ditegakkan dengan pemeriksaan radiologi, biopsi endometrium, dan pengukuran kadar serum beta-human chorionic gonadotropin (hCG). 3 Kami melaporkan perempuan berusia 50 tahun P2A0 dengan koriokarsinoma uterine. Pada pasien dilakukan kuretase pada tanggal 30 Juli 2022.…”

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

“…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 ).…”