Genetically Related Choriocarcinoma Developing 5 Yr After a Complete Hydatidiform Mole and Simulating a Cornual Ectopic Pregnancy

Life-threatening rupture of interstitial ectopic pregnancy: a rare presentation of metastatic invasive mole

An invasive mole is an uncommon type of gestational trophoblastic disease, and if considering its implantation in an interstitial extrauterine location, we are facing a rarer condition.There are 14 cases described of interstitial ectopic gestational trophoblastic disease. As far as we know, we present the third case of invasive mole within interstitial location, in this case with pulmonary metastases.The diagnosis of an interstitial implantation is challenging. Our patient was initially diagnosed with an intrauterine hydatidiform molar pregnancy, and a uterine aspiration was performed. Two weeks later, she presented with haemodynamical instability due to a severe haemoperitoneum. A laparotomy was immediately performed and revealed a ruptured interstitial pregnancy with molar vesicle extrusion. Besides its rarity, we highlight the clinical presentation with hypovolaemic shock due to rupture of ectopic pregnancy in a young nulliparous woman, which required an emergent surgical approach with lifesaving purpose while preserving future fertility.

Ovarian ectopic pregnancy misdiagnosed as gestational choriocarcinoma: A case report

Introduction

and importance: Choriocarcinoma is a highly malignant epithelial tumor with often distant metastasis. The clinical presentation of choriocarcinoma depends upon extend of disease and location of metastasis.

Case presentation

A 35-year-old multiparous woman was presented with severe pelvic pain, fatigue and cough. She was diagnosed with positive pregnancy due to elevated B-hCG and hyperechoic mass in right adnexa.

Clinical discussion

Exploration surgery showed a larger mass on the right ovary. She was diagnosed with choriocarcinoma however CT scan showed metastasis of lungs, brain and pelvis. She underwent multiple session of chemotherapy, nonetheless, after 8 months, she passed away.

Conclusion

Timely diagnosis and prompt treatment of choriocarcinoma is necessary to prevent mortality and bad prognosis. It should be differentially diagnosed with all the types of pregnancies.

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Choriocarcinoma is a highly malignant epithelial tumor with often distant metastasis.

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A 35-year-old multiparous woman was presented with severe pelvic pain, fatigue and cough.

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She was diagnosed with positive pregnancy due to elevated B-hCG and hyperechoic mass in right adnexa.

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Timely diagnosis and prompt treatment of choriocarcinoma is necessary to prevent mortality and bad prognosis.

Gestational trophoblastic neoplasia presenting as an interstitial ectopic pregnancy

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Gestational trophoblastic neoplasia (GTN) arising from interstitial ectopic pregnancy.

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Minimally invasive surgical management of interstitial ectopic pregnancy is feasible.

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GTN arising from interstitial ectopic pregnancies have favorable prognoses.

Gestational trophoblastic disease (GTD) is a group of benign and malignant tumors that develop from placental tissue and includes hydatidiform moles and gestational trophoblastic neoplasia (GTN). Invasive molar disease and choriocarcinoma are rare forms of GTN and can arise from any pregnancy event. An interstitial ectopic pregnancy occurs with implantation within the intramural portion of the fallopian tube covered by myometrium. We present two cases of an invasive mole with pathology consistent with choriocarcinoma in situ arising from an interstitial ectopic pregnancies. We review management strategies including a minimally invasive surgical approach. Additionally we present a review of the literature of gestational trophoblastic disease associated with interstitial ectopic pregnancies.