FIGO Stage III Metastatic Gestational Choriocarcinoma Developed From an Antecedent Partial Hydatidiform Molar Pregnancy Bearing a Numerical Chromosomal Aberration 68, XX: A Case Report and Literature Review.
A 36-yr-old, gravida 5 para 4 woman presented with uterine bleeding and was discovered to have a 3.7-cm uterine mass with multiple, bilateral, lung metastases. Six months earlier, the patient was diagnosed with a partial hydatidiform mole that demonstrated a rare chromosomal karyotype 68, XX[12]. The patient's serum β-human chorionic gonadotropin was elevated from baseline to 12,039 mIU/mL before the treatment. A total hysterectomy was performed and revealed a markedly hemorrhagic, extensively necrotic choriocarcinoma. The tumor mass invaded to a depth of 1/3 of the uterine wall thickness. Cytogenetic analysis of the choriocarcinoma revealed the same 68, XX karyotype, as observed in the antecedent partial hydatidiform mole. A clinical diagnosis of advanced stage invasive choriocarcinoma was rendered, with a risk factor score of 5. Following the development of chemoresistance to a single-agent (methotrexate) regimen, the patient subsequently received 5 cycles of chemotherapy (EMA-CO), without any major complication. She is currently >5 yr posttreatment and is asymptomatic. Her most recent imaging studies, including scans of chest and brain, show no evidence of disease, and her serum β-human chorionic gonadotropin level has remained consistently below detectable levels.
Departments of Pathology (N.M.), New Jersey Medical School, Newark Departments of Pathology (C.M.M.) Obstetrics and Gynecology (B.L.), Hackensack University Medical Center, Hackensack, New Jersey.
Naili
N
Ma
Babak
B
Litkouhi
Ciaran M
CM
Mannion
D000328:Adult; D002822:Choriocarcinoma / Q000235:genetics / Q000473:pathology*; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000235:genetics / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000235:genetics / Q000473:pathology*; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000235:genetics / Q000473:pathology*