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Gestational Choriocarcinoma of uterus with vaginal metastasis  [cached]
Vidyadhar B Bangal,Kunaal K. Shinde,Satyajit P. Gavhane,Rashmi K. Singh
International Journal of Biomedical and Advance Research , 2013, DOI: 10.7439/ijbar.v4i2.930
Abstract: Choriocarcinoma is a highly malignant tumour that arrise from trophoblastic tissue. It metastsize rapidly to vital organs including lungs and brain. It shows very good response to appropriately chosen chemotherapeutic regimen. A case of gestational choriocarcinoma with vaginal metastasis is reported. She responded very well to EMACO regime. Considering poor compliance for long term follow up, hysterectomy was done after 3 cycles of chemotherapy. She was disease free during three years of follow up.
Biljana Lazovi?,Vera Milenkovi?
Acta Medica Medianae , 2012,
Abstract: Choriocarcinoma is a highly malignant tumour which originates from the developing trophoblastic tissue, most commonly following molar pregnancy. It is a potentially fatal disease, but current management protocols have changed the prognosis as highly favourable. The aim of the study was to analyze the ways of establishing the diagnosis, methods and results of treatment of choriocarcinoma in our institute. The study was conducted as a retrospective analysis of the eight-year period, from 2000 to 2008. The obtained data were collected from medical charts with choriocarcinoma treated in our institute. In the eight-year period, eight cases of choriocarcinoma were registered. In one (12.5%) case choriocarcinoma developed after molar pregnancy, whereas in six (75%) cases the antecedent pregnancy resulted in a spontaneous abortion. In one patient the diagnosis was made after hysterectomy. Particular chemotherapeutic protocol was introduced to each patient. All patient survived. Prognosis of gestational choriocarcinoma is favourable provided the appropriate therapy is administered early in the course of disease. Provision of free medical care should be considered for these patients to save their lives.
Progress of the Diagnosis and Treatment of Pulmonary Metastasis of Gestational Choriocarcinoma  [cached]
Dongjie MA,Zhiyong ZHANG,Shanqing LI
Chinese Journal of Lung Cancer , 2011, DOI: 10.3779/j.issn.1009-3419.2011.10.06
Abstract: Gestational choriocarcinoma is the most common gestational trophoblastic neoplasia. It is prone to hematogenous metastasis, most commonly to the lungs. With the advent and development of chemotherapy, choriocarcinoma has become a curable tumor. However, patients with drug-resistant and recurrent choriocarcinoma are difficult to treat, even with the management of pulmonary metastasis. Resorting to surgery is also a tough decision given the challenges of identifying the appropriate surgical indication and timing. This review discusses the basic principles of management as well as recent advances in the diagnosis and treatment of patients with pulmonary metastasis of gestational choriocarcinoma.
Pure ovarian choriocarcinoma: report of two cases  [cached]
Narges Izadi-Mood,Nasrin Samadi,Parvaneh Rahimi-Moghaddam,Soheila Sarmadi
Journal of Research in Medical Sciences , 2009,
Abstract: Pure primary ovarian choriocarcinoma is an extremely rare condition of gestational or nongestational origin. The possibility of gestational origin can be suspected by the presence of a corpus luteum of pregnancy but definite diagnosis would be based on genetic analysis. Here, we present two cases of pure ovarian choriocarcinoma in the forth decade of life with the possibility of gestational origin. Keywords: Gestational, choriocarcinoma, ovary.
Gestational choriocarcinoma with hemorrhagic pleural effusion  [PDF]
Lazovi? Biljana,Milenkovi? Vera
Archive of Oncology , 2010, DOI: 10.2298/aoo1003086l
Abstract: Gestational trophoblastic disease (GTD) consists of a spectrum of disorders that are characterized by an abnormal proliferation of trophoblastic tissue. By virtue of their high vascularity and affinity of trophoblast for blood vessels, metastases often occur early and the most common site of such metastases is the lung. We described a case of a 34-year-old patient with pain in the left half of the chest, occasional, brief hemoptysis, and amenorrhea occurring in the period of 3 months. This presentation highlights the importance of analysis of HCG in the pleural puncture, for quick diagnosis and timely treatment.
Pure choriocarcinoma of ovary diagnosed by fine needle aspiration cytology  [cached]
Naniwadekar M,Desai S,Kshirsagar N,Angarkar N
Indian Journal of Pathology and Microbiology , 2009,
Abstract: Pure ovarian choriocarcinoma is extremely rare and can develop as a germ cell tumor or as a metastasis from uterine or tubal gestational choriocarcinoma or rarely from an ovarian pregnancy. The cytomorphologic findings have been reported previously in different sites. However, this is the first case of pure ovarian choriocarcinoma diagnosed on cytology to the best of our knowledge. The distinction between a gestational and nongestational choriocarcinoma is difficult. A 19-year-old female patient presented with an irregular per-vaginal bleeding and a mass in lower abdomen. Fine needle aspiration cytology smears of the mass were hypocellular and showed large, multinucleated giant cells and malignant mononucleated cells. Background was hemorrhagic. Serum β hCG level was 3,80,000 mIU/ml. A diagnosis of choriocarcinoma was offered which was later confirmed by histopathology. The diagnosis of choriocarcinoma on fine needle aspiration cytology is based on the presence of large, multinucleated giant cells and malignant mononucleated cells. A high index of suspicion should be maintained and estimation of serum β hCG plays a key role in supporting the diagnosis.
Spontaneous acute subdural hematoma as an initial presentation of choriocarcinoma: A case report
Brandon G Rocque, Mustafa K Ba?kaya
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-211
Abstract: The patient is a 34-year-old woman whose initial presentation of widely metastatic choriocarcinoma was an acute subdural hematoma, requiring decompressive craniectomy. Histopathologic examination of the tissue showed no evidence of choriocarcinoma, but the patient was found to have diffuse metastatic disease and cerebrospinal fluid indices highly suggestive of intracranial metastasis.Choriocarcinoma frequently metastasizes intracranially. We review the diverse possible manifestations of this process. In addition, the cerebrospinal fluid:serum beta-human chorionic gonadotropin ratio is an important factor in diagnosing these cases. Finally, the role of the neurosurgeon is discussed.Choriocarcinoma is a rare gestational trophoblastic disease that complicates approximately 1 in 50,000 term pregnancies and 1 in 30 hydatidiform moles[1]. Among confirmed cases of choriocarcinoma, 45% occur after molar pregnancy, 24% after normal term pregnancy, 25% after spontaneous abortion, and 5% after ectopic pregnancy[2]. Prognosis of this disease is generally good, 80–90% long-term survival with chemotherapy, radiotherapy, and surgical excision in appropriate cases[3]. One of the indicators of a poor prognosis is intracranial metastases, which complicate between 3 and 28% of gestational choriocarcinoma[1]. Here we report a case of subdural hematoma as the first presentation of choriocarcinoma and present a review of the literature pertaining to subdural hematoma in this setting.The patient is a 34-year-old woman who had an acute episode of excruciating headache and was later found obtunded. She had a history of a normal pregnancy three years prior to presentation. She then had an abnormal pregnancy requiring dilation and evacuation at 10–12 weeks that was found to be a molar pregnancy. She became pregnant again 9 months after the dilation and evacuation of the molar pregnancy. This ended in a spontaneous, uncomplicated delivery 5 months prior to her presentation. There was no histor
Incidental placental choriocarcinoma in a term pregnancy: a case report
Christopher Chung, Ming-Shian Kao, Deborah Gersell
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-330
Abstract: The patient is an 18 year-old Gravida 1 Para 1 African American female who delivered a viable 3641 g female infant at 39 weeks gestation. Her pregnancy course was complicated by gestational hypertension during the third trimester. Her placenta revealed intraplacental choriocarcinoma. She was then followed closely by the Gynecologic Oncology service with a weekly serum beta human chorionic gonadotropin value. Beta human chorionic gonadotropin values dropped from 3070 mIU/ml to less than 2 mIU/ml two months post partum. No chemotherapy was initiated. Metastasis was ruled out by chest x-ray and whole body computed tomography scan. To date, both mother and baby are well.Due to the potential fatal outcome of placental choriocarcinoma, careful evaluation of both mother and infant after the diagnosis is made is important. The incidence of placental choriocarcinoma may actually be higher than expected since it is not routine practice to send placentas for pathological evaluation after a normal spontaneous delivery. The obstetrician, pathologist, and pediatrician should have an increased awareness of placental choriocarcinoma and its manifestations.Gestational choriocarcinoma occurs in 1 in 40,000 pregnancies. It is a highly aggressive malignant tumor of the trophoblasts found in association with any form of gestation. Of all forms of gestational choriocarcinoma, placental choriocarcinoma is the most rare and is usually diagnosed in symptomatic patients with metastases. Metastases to the lung and brain usually occur in the mother, but metastatic choriocarcinoma in the fetus or neonates does occur. The incidental finding of a choriocarcinoma confined to the placenta with no evidence of dissemination to mother or infant is the least common scenario.The patient is an 18 year-old African American Gravida 1 Para 0 at her 39th weeks of gestation who presented to a hospital in the St. Louis area in early labor. After rupture of membranes, light meconium was noted. The patient subse
Non Gestational Cervical Choriocarcinoma With Urinary Bladder Metastases: An Unusual Case Report
Shweta Chawla Grover, Rani Bansal, Sangeeta, Nivesh Agarwal*, Anjali Khare, Veenu Jain
JK Science : Journal of Medical Education & Research , 2010,
Abstract: Primary cervical choriocarcinoma in a woman of child-bearing age with local infiltration into the urinarybladder wall in a 32 year old woman admitted to our hospital with haematuria and vaginal bleeding since 3months. Ultrasound examination revealed echogenic mass in urinary bladder lumen. Cystectomy withhysterectomy was done. Postoperative pathological examination of surgical specimen showed that casewas of primary choriocarcinoma of cervix with local infiltration into the urinary bladder wall.
Metastatic vulvo-vaginal choriocarcinoma mimicking a Bartholin cyst and vulvar hematoma-two unusual presentations  [cached]
Sanjoy Kumar Bhattacharyya,Shyama Prasad Saha,Gautam Mukherjee,Jaydeep Samanta
Journal of the Turkish-German Gynecological Association , 2012,
Abstract: Metastatic choriocarcinoma may present solely as a vulvo-vaginal growth. It may pose initial diagnostic dilemmas and thus treatment delay. Two cases of metastatic choriocarcinoma which presented as vulvo-vaginal swelling are described here. Both the cases were initially misdiagnosed. Later, unresponsiveness to treatment alerted us to the possibility of metastatic choriocarcinoma. Combination chemotherapy was started following diagnosis by serum β-HCG titer. In spite of initial responsiveness in both cases, one could not be saved due to poor compliance. Suspicion of metastatic choriocarcinoma should be kept in mind while dealing with any recent onset vulvovaginal swelling following a pregnancy. It may initially mislead the clinician due to its apparent benign appearance.
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