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Xu J, Xu Y, Xu C, Wang C. Morphological and molecular pathological features of the breast carcinoma with choriocarcinomatous features: A case report and a literature review. Front Oncol 2023; 13:984425. [PMID: 36969041 PMCID: PMC10031012 DOI: 10.3389/fonc.2023.984425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
Here we present a rare case of breast cancer with both invasive ductal carcinoma and choriocarcinoma components in a 55-year-old woman. Firstly, the serum human chorionic gonadotropin level showed 15.9mIU/ml preoperatively. And adequate immunohistochemical tests were performed on the specimen. Secondly, High-throughput sequencing was performed to detect the molecular characteristics of the two components, respectively. Then, DNA short tandem repeat (STR) analysis confirmed the homology of the two components, indicating the somatic origin of choriocarcinoma components. Finally, the clinical course and pathological characteristics of the case were reviewed and a literature search for other cases was performed.
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Pérez Montiel CA, Varela Aguirre GJ. Primary non-gestational choriocarcinoma of the uterine cervix. Int J Gynecol Cancer 2022; 32:111-112. [PMID: 34980664 DOI: 10.1136/ijgc-2021-003061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/04/2022] Open
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Anjum AS, Maqsood H, Younus S, Anjum S, Fatima M. A Rare Case of Non-Gestational Metastatic Ovarian Choriocarcinoma: Case Report and Literature Review With a Special Emphasis on Imaging. Cureus 2021; 13:e13121. [PMID: 33692915 PMCID: PMC7938442 DOI: 10.7759/cureus.13121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Non-gestational choriocarcinoma of the ovary is a very rare neoplasm. It carries a worse prognosis as compared to gestational choriocarcinoma (GCC). Here, we report a case of non-gestational ovarian choriocarcinoma. The patient initially presented in a medical emergency with abdominal pain, a feeling of heaviness in the lower abdomen, cough, and dyspnea. The patient had four healthy children, and the last childbirth was five years ago. There was no history of any abortion or stillbirth in the past four years. A highly vascular left adnexal mass was observed on ultrasound abdomen and pelvis. Compute CT chest, abdomen, and pelvis were performed, which revealed metastatic left ovarian choriocarcinoma features. It also showed vascular metastases of the carcinoma in the kidneys, liver, and lungs. We report this case specifically emphasizing ultrasound, multidetector computed tomography (MDCT), and CT angiography findings.
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Affiliation(s)
| | | | - Shifa Younus
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | - Sadia Anjum
- Radiology, Nishtar Medical University, Multan, PAK
| | - Maham Fatima
- Radiology, Nishtar Medical University, Multan, PAK
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Mangla M, Singla D, Kaur H, Sharma S. Unusual clinical presentations of choriocarcinoma: A systematic review of case reports. Taiwan J Obstet Gynecol 2017; 56:1-8. [PMID: 28254207 DOI: 10.1016/j.tjog.2015.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2015] [Indexed: 12/20/2022] Open
Abstract
Choriocarcinoma (CC) is a highly malignant tumor originating in the trophoblastic tissue. The clinical presentation of CC is so much varied that every case may be one of its kinds and thus can be a diagnostic challenge. Numerous case reports have been published in various journals regarding the unusual clinical presentations of this cancer. Therefore, we conducted a systematic review of all case reports in English language on gestational CC published in PubMed-indexed journals from 1998 to 2015. The main aim was to provide a summary and critical analysis of all the data and evidence published regarding the atypical clinical presentations of CC in recent years. In total, 121 case reports pertaining to unusual clinical manifestations of gestational CC were analyzed. The age of patients in whom cases were reported ranged from 17 to 67 years, and the time period between the index pregnancy and development of CC varied from 4 weeks to as long as 25 years. Cardiopulmonary complaints (20.66%) followed by gastrointestinal (18.43%) and central nervous system manifestations (17.67%) were found to be the most common. Through this review, the authors have made an attempt to discuss various manifestations with which a patient with gestational CC can present to clinician so that early diagnosis and timely management can be initiated, thus improving clinical prognosis.
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Affiliation(s)
- Mishu Mangla
- Department of Gynecology and Obstetrics, GianSagar Medical College and Hospital, Banur, Punjab, India.
| | - Deepak Singla
- Department of Anesthesia, BPS Govt. Medical College, Khanpur Kalan, Sonipat, Haryana, India
| | - Harpreet Kaur
- Department of Gynecology and Obstetrics, GianSagar Medical College and Hospital, Banur, Punjab, India
| | - Sushmita Sharma
- Department of Gynecology and Obstetrics, GianSagar Medical College and Hospital, Banur, Punjab, India
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Hwang DW, Song HS, Choi YY, Kim HS, Kim YA, Chun KC. Primary non-gestational choriocarcinoma of the uterine cervix with metaplastic transformation from adenocarcinoma: a case report. J OBSTET GYNAECOL 2017; 38:289-290. [PMID: 28830246 DOI: 10.1080/01443615.2017.1336756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Dong Won Hwang
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
| | - Hyoun Sook Song
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
| | - Yun Yeon Choi
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
| | - Hee Sun Kim
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
| | - Young Ah Kim
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
| | - Kyoung-Chul Chun
- a Department of Obstetrics and Gynecology , Inje University College of Medicine, Ilsan-Paik Hospital , Gyeonggi , Korea
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Yadav BS, Rai B, Suri V, Mukherjee KK, Bal A, Morgan R, Shonka NA, Lele S, Morris GJ. A Young Female With Metastatic Nongestational Choriocarcinoma. Semin Oncol 2015; 42:e109-15. [PMID: 26615138 DOI: 10.1053/j.seminoncol.2015.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Park M, Han SS, Lee EJ, Byon M, Kim MY, Kim MK, Kim GJ. Primary cervical choriocarcinoma during viable intrauterine pregnancy. J Obstet Gynaecol Res 2015; 41:1291-4. [PMID: 25976497 DOI: 10.1111/jog.12715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 02/07/2015] [Accepted: 02/19/2015] [Indexed: 12/01/2022]
Abstract
A 31-year-old multigravida woman at 27 weeks' gestation was admitted with vaginal bleeding and a hypervascular mass near the cervix on ultrasonography. After discharge with improvement, she was readmitted the next day for uncontrolled, heavy vaginal bleeding and underwent emergency cesarean section at 29 weeks' gestation. A 3-cm friable mass found near the cervix was removed surgically; this lesion was shown to be primary cervical choriocarcinoma. On the 17th postoperative day the patient underwent total abdominal hysterectomy with preservation of both ovaries and biopsy was performed on the right ovary. The International Federation of Gynecology and Obstetrics (FIGO) stage was I and her World Health Organization prognostic score was 9, representing high risk. The patient received three rounds of chemotherapy until achieving three consecutive normal human chorionic gonadotropin levels with two additional courses to address risk of relapse. DNA genotyping on short tandem repeat polymorphism confirmed the gestational choriocarcinoma.
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Affiliation(s)
| | | | - Eun-Ju Lee
- Departments of Obstetrics and Gynecology
| | - Mina Byon
- Departments of Obstetrics and Gynecology
| | | | - Mi-Kyung Kim
- Pathology, Chung-Ang University College of Medicine, Seoul, Korea
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Abstract
Choriocarcinoma is a highly malignant epithelial tumor originating from trophoblast. It primarily occurs during the fertile period. Postmenopausal uterine choriocarcinoma is very rare. We present a case of choriocarcinoma in a postmenopausal lady developing 5 years after menopause. She presented with heavy postmenopausal bleeding along with passage of vesicles per vaginum. Serum beta-hCG was 96,484 mIU/ml. Emergency abdominal hysterectomy with bilateral salpingo-ooperectomy was done due to intractable bleeding following suction and evacuation. Histopathology revealed uterine choriocarcinoma. She was treated with EMACO regimen following which her beta-hCG returned to normal in five cycles. The patient is under regular follow-up and is doing well.
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Affiliation(s)
- Sunil K Samal
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Setu Rathod
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
| | - Seetesh Ghose
- Department of Obstetrics and Gynaecology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
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Maehira H, Shimizu T, Sonoda H, Mekata E, Yamaguchi T, Miyake T, Ishida M, Tani T. A rare case of primary choriocarcinoma in the sigmoid colon. World J Gastroenterol 2013; 19:6683-6688. [PMID: 24151399 PMCID: PMC3801386 DOI: 10.3748/wjg.v19.i39.6683] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/08/2013] [Accepted: 08/13/2013] [Indexed: 02/06/2023] Open
Abstract
Primary colorectal choriocarcinoma is an extremely rare neoplasm and is usually associated with a poor prognosis. Only 13 cases of colorectal choriocarcinoma have previously been reported. There is no standard chemotherapeutic regimen for this tumor type. A 68-year-old man presented with melena and was diagnosed with sigmoid colonic adenocarcinoma with multiple liver metastases. He underwent a laparoscopic sigmoidectomy. Pathology revealed choriocarcinoma with a focal component of moderately differentiated adenocarcinoma of colon origin. Based on the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) results, mFOLFOX6 and bevacizumab were administered, which suppressed aggressive tumor growth for 4 mo. The patient died 9 mo after the initial diagnosis. Our study results suggest that the standard chemotherapy regimen for colorectal cancer might have suppressive effects against primary colorectal choriocarcinoma. Moreover, CD-DST may provide, at least in part, therapeutic insight for the selection of appropriate antitumor agents for such patients.
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MESH Headings
- Adenocarcinoma/complications
- Adenocarcinoma/pathology
- Adenocarcinoma/secondary
- Adenocarcinoma/therapy
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bevacizumab
- Biopsy
- Chemotherapy, Adjuvant
- Choriocarcinoma, Non-gestational/complications
- Choriocarcinoma, Non-gestational/pathology
- Choriocarcinoma, Non-gestational/secondary
- Choriocarcinoma, Non-gestational/therapy
- Colectomy
- Colonoscopy
- Disease Progression
- Drug Screening Assays, Antitumor
- Fatal Outcome
- Humans
- Liver Neoplasms/secondary
- Male
- Melena/etiology
- Neoplasms, Complex and Mixed/complications
- Neoplasms, Complex and Mixed/pathology
- Neoplasms, Complex and Mixed/secondary
- Neoplasms, Complex and Mixed/therapy
- Sigmoid Neoplasms/complications
- Sigmoid Neoplasms/pathology
- Sigmoid Neoplasms/therapy
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
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Wakahashi S, Sudo T, Nakagawa E, Ueno S, Muraji M, Kanayama S, Itami H, Kawakami F, Yamada T, Yamaguchi S, Fujiwara K, Nishikawa H, Nishimura R, Ohbayashi C. Endometrioid adenocarcinoma with high-grade transformation with serous and choriocarcinomatous differentiation - a case report. J Cancer 2012; 3:14-8. [PMID: 22211141 PMCID: PMC3245604 DOI: 10.7150/jca.3.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 11/24/2011] [Indexed: 12/01/2022] Open
Abstract
A choriocarcinoma component with a malignant tumor is relatively rare. We present a case of an 85-year-old woman with mixed carcinoma, which was endometrioid adenocarcinoma with squamous differentiation, choriocarcinoma and a disseminated peritoneal nodule, which was papillary serous adenocarcinoma. The patient received surgery and conservative treatment. Twenty weeks after surgery, a recurring tumor appeared at the Douglas pouch. Histology showed that the recurring tumor was poorly differentiated carcinoma that was very different from the primary tumor. This case represents an unusual uterine corpus cancer with high-grade transformation with serous and choriocarcinomatous differentiation. This case also demonstrates the capacity of tumor cells to differentiate into divergent elements.
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Affiliation(s)
- Senn Wakahashi
- 1. Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo 673-8558, Japan
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Longo R, Battaglia F, Gattuso D, De Sio L, Sarmiento R, Amici S, Gasparini G. Primary Nongestational Choriocarcinoma of the Uterine Cervix. J Clin Oncol 2011; 29:e301-2. [DOI: 10.1200/jco.2010.33.2361] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Desai NR, Gupta S, Said R, Desai P, Dai Q. Choriocarcinoma in a 73-year-old woman: a case report and review of the literature. J Med Case Rep 2010; 4:379. [PMID: 21108779 PMCID: PMC3002375 DOI: 10.1186/1752-1947-4-379] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Accepted: 11/25/2010] [Indexed: 01/11/2023] Open
Abstract
Introduction Choriocarcinoma is a highly malignant tumor of trophoblastic origin. Most cases present within one year of the antecedent pregnancy (molar or non-molar). However, very rarely, choriocarcinoma can develop from germ cells or from dedifferentiation of endometrial carcinoma into choriocarcinoma. This article concerns a case of choriocarcinoma developing 38 years after the patient's last pregnancy and 23 years after menopause. Case presentation A 73-year-old African-American woman presented with a three-week history of vaginal bleeding. A vaginal mass was seen on pelvic examination. Ultrasonography showed a thickened complex endometrial echo. Her β-human chorionic gonadotrophin level was found to be elevated (2,704,040 mIU/mL). Vaginal and uterine biopsies were suggestive of choriocarcinoma. Immunohistochemistry tests were positive for β-human chorionic gonadotrophin as well as cytokeratin and negative for octamer binding transcription factor 3/4 and α-fetoprotein, supporting the diagnosis of choriocarcinoma. A combination of etoposide, methotrexate, and dactinomycin, followed by cyclophosphamide and vincristine (the so-called EMA/CO regimen) was initiated. After seven cycles of chemotherapy, her β-human chorionic gonadotrophin level dropped below 5 mIU/mL. Our patient is being followed up at our oncology institute. Conclusions We report an extremely rare case of choriocarcinoma arising 23 years after menopause. A postmenopausal woman presenting with vaginal bleed from a mass and β-human chorionic gonadotrophin elevation should be evaluated by immunohistochemical analysis to rule out the possibilities of a germ cell origin of the tumor or dedifferentiation of an epithelial tumor. Absence of octamer binding transcription factor 3/4, α-fetoprotein and CD-30 staining helps in exclusion of most germ cell tumors. DNA polymorphism studies can be used to differentiate between gestational and non-gestational tumor origin. These require fresh tissue samples and are time consuming. Finally, the effective first-line therapy for β-human chorionic gonadotrophin-producing high-risk gestational as well as non-gestational trophoblastic tumors is combination chemotherapy (the EMA/CO regimen). Therefore, treatment should be commenced when a potential diagnosis of metastatic trophoblastic tumor is being considered.
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Affiliation(s)
- Nisarg R Desai
- Department of Medicine, Staten Island University Hospital, Staten Island, New York, USA.
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Pavelka JC, Bryant DA, Vaccarello L. Adenocarcinoma of the uterine cervix with choriocarcinomatous metastasis. Gynecol Oncol 2006; 101:346-8. [PMID: 16430947 DOI: 10.1016/j.ygyno.2005.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Revised: 11/02/2005] [Accepted: 11/04/2005] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nongestational choriocarcinoma, in very rare instances, has been described as a component of other malignancies with a tendency for a very poor prognosis. CASE A 55 year old woman was diagnosed with adenocarcinoma of the cervix, and incompletely treated with only external beam radiation. Adjuvant radical hysterectomy demonstrated no residual tumor, but the patient developed a tumor metastasis mimicking a pulmonary artery thrombus which by histology and immunohistochemistry was pure choriocarcinoma. While chemotherapy was successful in achieving a complete remission, the patient succumbed to complications of her pulmonary metastasis. CONCLUSION Choriocarcinomatous dedifferentiation of cervical adenocarcinoma is extremely rare, with only one other case reported in the literature. While the prognosis for patients with such a tumor is generally poor, aggressive combination chemotherapy may be of benefit in some.
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Affiliation(s)
- James C Pavelka
- The Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 160 W, Los Angeles, CA 90048, USA.
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