Mixed choriocarcinoma in a postmenopausal patient.
Gestational trophoblastic disease rarely presents in patients beyond the reproductive years. To our knowledge, this is the first case of mixed trophoblastic disease in a postmenopausal woman. We present here a case of a 60-year-old woman with evidence of a pelvic mass and pulmonary metastasis. Surgery revealed an 8 x 6 x 6 cm multinodular uterine tumor involving the right adnexa. Histologic review was consistent with choriocarcinoma with intermediate trophoblastic features. Postoperative beta-hCG was 381 561 mIU/ml. We conclude that maintaining a high index of suspicion facilitates the identification of postmenopausal patients with metastatic gestational trophoblastic disease. This case reconfirms the deceptive presentation of the "great masquerader".
Ramondetta
L M
LM
Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. lramonde@mail.mdanderson.org
Silva
E G
EG
Levenback
C F
CF
Burke
T W
TW
D002822:Choriocarcinoma / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008875:Middle Aged; D017698:Postmenopause; D014327:Trophoblasts / Q000473:pathology*; D014594:Uterine Neoplasms / Q000473:pathology*