title: Abnormal Presentation of Choriocarcinoma and Literature Review.
abstract: BACKGROUND
  Gestational trophoblastic neoplasms have highly been malignant potential, which usually occurred in child-bearing age women. Unusual feature of this malignancy would be rare, it was important to take in mind the possibility of GTN in different manifestation. Based on the above mentioned, the aim of this presentation would be the management and outcome of a case series of choriocarcinoma patients with abnormal manifestation.
  
  
  METHODS
  We have presented four patients, first who initially manifestation with signs of septic shock, the second case with severe gastrointestinal hemorrhage, the third case with postpartum infection and the forth case was a postmenopausal bleeding patient.
  
  
  CONCLUSIONS
  In case of metastatic choriocarcinoma with precise history, accurate diagnosis and appropriate treatment have led us to curable results.
authors.affiliation: Department of Obstetrics and Gynecology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Yousefi
authors.affiliation: Department of Obstetrics and Gynecology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Mansorhe
authors.initials: M
authors.lastname: Mottaghi
authors.affiliation: Islamic Azad University, Mashhad, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Rezaei
authors.affiliation: Department of Obstetrics and Gynecology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Sedighe
authors.initials: S
authors.lastname: Ghasemian
keywords: Chemotherapy; Choriocarcinoma; Gastrointestinal hemorrhage; Gestational Trophoblastic Disease; Postmenopausal Hemorrhage