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Bekele FS, Beyene AD, Belete DT, Moges MB, Gebregiorgis BT. Choriocarcinoma metastatic to both kidneys presenting with spontaneous renal hemorrhage: Case report. Int J Surg Case Rep 2024; 119:109649. [PMID: 38696929 PMCID: PMC11070237 DOI: 10.1016/j.ijscr.2024.109649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/04/2024] [Accepted: 04/18/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION Choricocarcinoma is a highly malignant tumor. It metastasize commonly to the lungs. Metastasis to the kidney is uncommon, and bilateral metastasis is described rarely. Initial presentation with spontaneous bleeding of the renal metastatic tumor is scarce in the literatures. Here we present a case report of a choriocarcinoma patient with bilateral renal metastasis, presenting with spontaneous renal hemorrhage. CASE PRESENTATION A 22 years old female presented to our emergency department with sudden onset of left flank pain. She has history of spontaneous abortion 02 years back with biopsy from the manual vacuum aspiration (MVA) showing molar pregnancy. Up on evaluation, patient was anemic. CT scan showed left renal bleeding tumor. Exploratory laparotomy and radical nephrectomy was done with the impression of bleeding renal cell carcinoma. The biopsy revealed choriocarcinoma. On her follow up, CT scan showed right renal and brain metastasis. She was given multi agent chemotherapy and her serum beta-hCG became undetectable after 01 year. DISCUSSION Choriocarcinoma can be gestational or nongestational. The commonest route of metastasis is hematogenous. Presenting symptoms of renal metastasis can be hematuria, pain or more commonly incidental finding during work up. Choriocarcinoma is highly chemo sensitive. CONCLUSION Bilateral renal metastatic choriocarcinoma is uncommon. Spontaneous renal hemorrhage as an initial presentation is even rare, and it can mimic a bleeding renal cell carcinoma. High index of suspicion is needed in a young women with recent history of spontaneous abortion.
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Affiliation(s)
- Fitsum Solomon Bekele
- Tikur Anbessa Specialized Hospital, Addis Ababa University, College of Health Sciences, School of Medicine, Ethiopia.
| | - Andualem Deneke Beyene
- Tikur Anbessa Specialized Hospital, Addis Ababa University, College of Health Sciences, School of Medicine, Ethiopia
| | - Dagnachew Tamrat Belete
- Tikur Anbessa Specialized Hospital, Addis Ababa University, College of Health Sciences, School of Medicine, Ethiopia
| | | | - Bemnet Taye Gebregiorgis
- Tikur Anbessa Specialized Hospital, Addis Ababa University, College of Health Sciences, School of Medicine, Ethiopia
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Zhang H, Zhao Y, Wang JN, Zhao HT. Renal metastatic choriocarcinoma with rupture and hemorrhage: A case report of unknown primary. Asian J Surg 2023; 46:5238-5239. [PMID: 37479663 DOI: 10.1016/j.asjsur.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/09/2023] [Indexed: 07/23/2023] Open
Affiliation(s)
- Heng Zhang
- Urology Department of the First People's Hospital of Dali, Yunnan Province, No. 36 Taian Road, Dali City, China
| | - Yan Zhao
- Urology Department of the First People's Hospital of Dali, Yunnan Province, No. 36 Taian Road, Dali City, China
| | - Jin-Nan Wang
- Urology Department of the First People's Hospital of Dali, Yunnan Province, No. 36 Taian Road, Dali City, China
| | - Heng-Tai Zhao
- Urology Department of the First People's Hospital of Dali, Yunnan Province, No. 36 Taian Road, Dali City, China.
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Pahwa S, Sharma A, Kamboj M, Gupta G, Pasricha S. Metastatic choriocarcinoma of the kidney in the absence of existing primary uterine tumor: A rare presentation. J Cancer Res Ther 2023; 19:819-822. [PMID: 37470618 DOI: 10.4103/jcrt.jcrt_1880_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Gestational choriocarcinomas are malignant neoplasms generally arising in the uterus in women of childbearing age. These are aggressive tumors with a high incidence of metastasis to vascular organs such as the lung, liver, and brain. Renal metastasis is extremely rare with low incidence rate and very few cases have been reported in literature. Hereby, we report a rare case of metastatic choriocarcinoma to the kidney in a 29-year-old female 10 years after resection of a hydatidiform mole. The histopathological diagnosis was made on a nephrectomy specimen. Pelvic and abdominal scan did not show any abnormal radiological findings. She was started on first-line chemotherapy and showed a complete response. In conclusion, gestational or primary nongestational choriocarcinomas should always be considered as a differential diagnosis in young females of reproductive age group presenting with flank abdominal pain, unexplained hematuria, and atypical renal tumor histology.
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Affiliation(s)
- Saloni Pahwa
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Anila Sharma
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Meenakshi Kamboj
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Gurudutt Gupta
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Sunil Pasricha
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
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Basida B, Zalavadiya N, Khicher S, York R. Haemoptysis in third trimester-sole manifestation of stage IV gestational choriocarcinoma. BMJ Case Rep 2021; 14:14/4/e241870. [PMID: 33875512 PMCID: PMC8057579 DOI: 10.1136/bcr-2021-241870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gestational choriocarcinoma is a rare neoplasm of pregnancy that is often undiagnosed until the advanced stage manifests with metastatic complications. Herein, we present a case of a 22-year-old young woman with metastatic gestational choriocarcinoma with unidentified primary origin, who presented with haemoptysis as a chief problem in her third trimester. The case emphasises on the rarity of this neoplasm in a viable pregnancy. Prompt diagnosis and treatment is the key for good maternal and fetal prognosis.
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Affiliation(s)
- Brinda Basida
- Department of Internal Medicine, Sinai Grace Hospital, Detroit, Michigan, USA
| | - Nirav Zalavadiya
- Department of Internal Medicine, Sinai Grace Hospital, Detroit, Michigan, USA
| | - Suman Khicher
- Department of Rheumatology, Detroit Medical Center, Detroit, Michigan, USA
| | - Russel York
- Department of Rheumatology, Detroit Medical Center, Detroit, Michigan, USA
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He Y, Bhoopathy V, Habashy D, Adams S, McCombie SP, Arianayagam M. Spontaneous bleeding from an unusual renal mass: A case of gestational choriocarcinoma related to previous pregnancy over a decade earlier. Urol Case Rep 2021; 37:101614. [PMID: 33842209 PMCID: PMC8020421 DOI: 10.1016/j.eucr.2021.101614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 10/27/2022] Open
Abstract
Gestational choriocarcinoma is an uncommon trophoblastic malignancy, occurring in females after pregnancy, which is rarely encountered by urologists. It can be rapidly progressive, however metastases to other organs can occur after a prolonged latency period. We describe a rare case of solitary metastatic gestational choriocarcinoma presenting with spontaneous bleeding from a renal mass, over a decade after the associated pregnancy with a presumed sub-clinical primary tumour. This case demonstrates the importance of recognising gestational choriocarcinoma as a potential differential diagnosis of spontaneous bleeding renal mass in females of child-bearing age as a urologist given the often-aggressive nature of the disease.
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Affiliation(s)
- Yilu He
- Nepean Urology Research Group, Nepean Hospital, Kingswood, NSW, Australia
| | - Varun Bhoopathy
- Nepean Urology Research Group, Nepean Hospital, Kingswood, NSW, Australia
| | - David Habashy
- Nepean Urology Research Group, Nepean Hospital, PO Box 63, Penrith, NSW, 2751, Australia
| | - Stuart Adams
- NSW Health Pathology, Nepean Hospital, Penrith, NSW, 2751, Australia
| | - Steve P McCombie
- Nepean Urology Research Group, Nepean Hospital, Kingswood, NSW, Australia.,Fiona Stanley Hospital, Murdoch, WA, Australia.,University of Western Australia, Crawley, WA, Australia
| | - Mohan Arianayagam
- Nepean Urology Research Group, Nepean Hospital, Kingswood, NSW, Australia
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Orisaka S, Kagami K, Mizumoto Y, Koda W, Ono M, Nakamura M, Fujiwara H. Successful detection of SRY gene via fine needle biopsy: A case of extragenital gestational choriocarcinoma in the kidney. Mol Clin Oncol 2017; 7:1057-1060. [DOI: 10.3892/mco.2017.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/13/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Shunsuke Orisaka
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Kyosuke Kagami
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Yasunari Mizumoto
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Wataru Koda
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Mitsuhiro Nakamura
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
| | - Hiroshi Fujiwara
- Department of Obstetrics and Gynecology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920‑8641, Japan
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Li HM, Hou WC, Lai YJ, Kao CC, Chao TK, Yu MH, Su HY. Gestational choriocarcinoma with renal and pulmonary metastases lacking a primary uterine origin. Taiwan J Obstet Gynecol 2017; 55:881-885. [PMID: 28040140 DOI: 10.1016/j.tjog.2015.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We describe a case of gestational choriocarcinoma metastasized to the kidney and lung, which presented initially as refractory hematuria after a term pregnancy 5 years earlier. CASE REPORT A 35-year-old woman, G2P1, with a previous history of full-term pregnancy in 2009, presented to the emergency department complaining of intermittent gross hematuria for 2 months. Abdominal computed tomography showed a suspicious arteriovenous malformation in the right kidney and a thrombus within the right renal vein. Transarterial embolization was performed twice to treat the refractory hematuria but was unsuccessful, and radical nephrectomy of the right kidney was performed. The diagnosis was gestational metastatic choriocarcinoma of the kidney based on morphological, immunohistochemical, and DNA studies. Lung metastases were found by computed tomography of the chest. Pelvic ultrasound was performed but showed no primary tumor in the uterine cavity. After surgical intervention, adjuvant chemotherapy involving first single-agent chemotherapy with methotrexate followed by multiagent chemotherapy (EMACO regimen) failed. CONCLUSION In women of reproductive age, unexplained hematuria should raise concerns about possible choriocarcinoma, either metastatic gestational or primary nongestational choriocarcinoma of the kidney.
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Affiliation(s)
- Hao-Ming Li
- Department of General Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Chien Hou
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ju Lai
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Chang Kao
- Section of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tai-Kuang Chao
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Mu-Hsien Yu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Her-Young Su
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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