Postmenopausal choriocarcinoma: A rare case report

An Unusual Presentation of Choriocarcinoma in a Postmenopausal Woman: A case report

Choriocarcinoma (CC) is a malignant neoplasm of the trophoblastic tissue, with a potential to metastasise to distant organs. Limited case of gestational CC develops after a long latent period. We report a 52-year-old postmenopausal woman who developed metastatic choriocarcinoma presumably of gestational origin, 8 years after the last pregnancy and 2 years after the last menstrual period. The patient was brought to the emergency room of a tertiary care centre in Muscat, Oman, in 2022 and was diagnosed with CC metastatic to the brain, spleen, lung and the kidney. The β-human chorionic gonadotrophin level was found to be raised (1,292,867 mIU/mL). The International Federation of Gynecologic Oncology risk score was calculated to be 14 (very high risk). The patient was initially treated with whole-brain radiotherapy and splenic artery embolisation because of a hemoperitoneum. Afterwards the patient received systemic treatment using the standard EMA/CO regimen till complete serological remission.

Pure nongestational uterine choriocarcinoma in postmenopausal women: a case report with literature review

Nongestational choriocarcinoma is rare, especially in postmenopausal women. It may be derived from the transformation of germ cells or dedifferentiation of other tumor tissue cells. It is usually found in the ovaries but rarely in the uterus. Pure nongestational uterine choriocarcinoma in postmenopausal women is exceptional. Thirty-four cases of choriocarcinoma have been found during the past 25 y at the Tianjin Medical University General Hospital. We retrospectively reviewed the medical records of these 34 cases and found only two cases of nongestational uterine choriocarcinoma, both of which were postmenopausal women. We also reviewed 19 other cases previously reported during the past 50 y (from 1970 to 2018) that were identified as uterine choriocarcinoma in postmenopausal women. Analysis of these combined data indicates that nongestational choriocarcinoma is a rare neoplasm in postmenopausal patients. It genetically originates entirely in the patient, and short tandem repeat (STR) analyses are usually required to differentiate gestational and nongestational choriocarcinoma. Although nongestational choriocarcinoma shows some response to chemotherapy, sensitivity is much poorer than that in gestational choriocarcinoma. The prognosis for nongestational choriocarcinoma is poor and the long-term survival rate is low.