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Meddeb S, Rhim MS, Zarrouk W, et al. Unusual gestational choriocarcinoma arising in an interstitial pregnancy. Int J Surg Case Rep. 2014;5(11):787-8doi: 10.1016/j.ijscr.2014.08.025.
Meddeb, S., Rhim, M. S., Zarrouk, W., Bibi, M., Yacoubi, M. T., & Khairi, H. (2014). Unusual gestational choriocarcinoma arising in an interstitial pregnancy. International journal of surgery case reports, 5(11), 787-8. https://doi.org/10.1016/j.ijscr.2014.08.025
Meddeb, Sawsen, et al. "Unusual gestational choriocarcinoma arising in an interstitial pregnancy." International journal of surgery case reports vol. 5,11 (2014): 787-8. doi: https://doi.org/10.1016/j.ijscr.2014.08.025
Meddeb S, Rhim MS, Zarrouk W, Bibi M, Yacoubi MT, Khairi H. Unusual gestational choriocarcinoma arising in an interstitial pregnancy. Int J Surg Case Rep. 2014;5(11):787-8. doi: 10.1016/j.ijscr.2014.08.025. Epub 2014 Sep 16. PMID: 25290382; PMCID: PMC4245668.
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Int J Surg Case Rep. 2014;5(11):787-8. doi: 10.1016/j.ijscr.2014.08.025. Epub 2014 Sep 16.

Unusual gestational choriocarcinoma arising in an interstitial pregnancy.

International journal of surgery case reports

Sawsen Meddeb, Mohamed Salah Rhim, Wissal Zarrouk, Mohamed Bibi, Mohamed Tahar Yacoubi, Hedi Khairi

Affiliations

  1. Department of Gynecology and Obstetrics, Farhat Hached University Hospital, Sousse, Tunisia; Research Laboratory in Quality of Maternal Health Care in Tunisia. Electronic address: [email protected].
  2. Department of Gynecology and Obstetrics, Farhat Hached University Hospital, Sousse, Tunisia.
  3. Department of Pathology, Farhat Hached University Hospital, Sousse, Tunisia.

PMID: 25290382 PMCID: PMC4245668 DOI: 10.1016/j.ijscr.2014.08.025

Abstract

INTRODUCTION: Choriocarcinoma is a highly malignant trophoblastic neoplasm. Its association with ectopic pregnancy is very rare and usually with aggressive behavior.

PRESENTATION OF CASE: We report a new case arising in an interstitial pregnancy occurring in a 46-year-old woman. The patient was admitted for severe pelvic pain and abundant metrorrhagia. One month ago, she had had a laparoscopic resection of an interstitial pregnancy subsequent to failure of chemotherapy by methotrexate. The raise of serum βhCG level and the hyperechoic intrauterine mass were in favor of gestational trophoblastic disease. Urgent laparotomy was performed for circulatory collapse. Hysterectomy was done. Histological examination revealed a choriocarcinoma. The patient underwent chemotherapy. Two years later, neither metastasis nor recurrence was detected.

DISCUSSION: Clinical diagnosis of primary interstitial choriocarcinoma is difficult, since it is rare and manifesting by non-specific abnormal vaginal bleeding. Imaging findings are also not helpful in ectopic location. The frequency of metastasis is related to the delayed diagnosis. Serial measurement of βhCG level was the most useful marker of diagnosis and follow up. Histopathological examination remains the only tool of the precise diagnosis. Choriocarcinoma has a very good prognosis even in advanced stages, since it is very chemosensitive.

CONCLUSION: The current trend of the treatment of ectopic pregnancy by conservative surgery requires adequate monitoring of βhCG and careful examination of pathologic specimens to avoid misdiagnosis of ectopic gestational trophoblastic disease.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Choriocarcinoma; Ectopic pregnancy; Gestational trophoblastic disease; Interstitial pregnancy

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