Gestational choriocarcinoma with pulmonary and vaginal metastasis in a 35 week pregnant woman: A case report

Abstract

Gestational choriocarcinoma coexisting with a normal pregnancy, especially in the third trimester is extremely rare and difficult to diagnose. Case: A 26-year-old patient, PARA 4004, was admitted to the National Hospital of Obstetrics and Gynecology at the 35th week of gestation with a diagnosis of fetal distress and bleeding from vaginal metastasis of trophoblastic tumor, beta hCG 626825 IU/L. The patient performed an emergency cesarean section and removed a vaginal tumor due to rupture 6 days after the operation. The pathological result was choriocarcinoma. Chest X-ray showed scattered opacities in two lung fields. The woman was treated with EMACO. After 3 cycles, chest X-ray showed no lesions, beta hCG decreased to 8IU/L. A laparoscopic total hysterectomy was performed. She received the 4th course of EMACO before quitting the treatment by herself. After 1 year of disease onset, the patient and her child are in stable health. If
gestational choriocarcinoma coexisting with a viable pregnancy is diagnosed and treated early, the response to treatment and prognosis are quite hopeful and help to avoid serious complications for the mother and fetus.