Primary abdominal gestational choriocarcinoma.
BACKGROUND
Gestational choriocarcinoma associated with ectopic pregnancy is an extremely infrequent event. Primary abdominal gestational choriocarcinoma has not been previously described.


METHODS
A pregnant woman presented to the emergency room with 6 days of vaginal spotting. Her last menstrual period suggested a gestation at 6 4/7 weeks. Transvaginal sonogram showed a hemoperitoneum with no intrauterine pregnancy. The serum human chorionic gonadotropin level was noted to be 317,735 mIU/mL. A 20 x 20-mm friable, bleeding mass on the left anterior abdominal wall was laparoscopically resected. Gestational choriocarcinoma was identified on histopathologic review. International Federation of Gynecology and Obstetrics stage IV:4 was assigned, and the patient achieved clinical remission with combination chemotherapy.


CONCLUSIONS
Primary abdominal gestational choriocarcinoma can present with findings similar to a ruptured ectopic pregnancy; it should be treated by surgical excision and chemotherapy.
Bailey
Jennifer L
JL
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Southwestern Trophoblastic Disease Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9032, USA.
Hinton
Emily A
EA
Ashfaq
Raheela
R
Schorge
John O
JO
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002822:Choriocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D011247:Pregnancy; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology