Obstet Gynecol Sci.  2014 Nov;57(6):544-548. 10.5468/ogs.2014.57.6.544.

Retroperitoneal nongestational choriocarcinoma in a 25-year-old woman

• Park SY
• Lee DE
• Park HJ
• Kim KC
• Kim YH

• KMID: 2314025
• DOI: http://doi.org/10.5468/ogs.2014.57.6.544

Abstract

Choriocarcinoma is a highly invasive and metastatic neoplasm which arises in women of reproductive age. It can be either gestational or nongestational in origin, but the latter form is very rare. Choriocarcinoma is characterized by the production of human chorionic gonadotropin. It can metastasize to distant organs such as lung, brain, liver, kidney, and vagina in the early stages of disease, but retroperitoneal metastasis is extremely rare. Treatment options include surgical intervention and chemotherapy. We present the case of a 25-year-old nulliparous woman who presented to our department with a retroperitoneal mass and negative urine human chorionic gonadotropin test, who was immunohistopathologically diagnosed with nongestational choriocarcinoma. The patient responded well to surgery and multi-drug chemotherapy.

Keyword

Chorionic gonadotropin; Nongestational choriocarcinoma; Retroperitoneum

MeSH Terms

Adult*
Brain
Choriocarcinoma*
Chorionic Gonadotropin
Drug Therapy
Female
Humans
Kidney
Liver
Lung
Neoplasm Metastasis
Pregnancy
Vagina
Chorionic Gonadotropin

Figure

• 

  Fig. 1 (A) Transabdominal ultrasonographic findings of the mass in left adnexal region. The mass is encircling left common and external iliac artery. (B) Magnetic resonance imaging shows heterogenous enhancing mass (arrow) in left retroperitoneum which is encircling left iliac vessel. (C) Positron emission tomography demonstrates suspicious malignant mass in left iliac region, recto-uterine pouch, and left side of the uterus.

• 

  Fig. 2 (A) Gross photography. (B) The cut section of the tumor shows a hemorrhage and some necrotic portion with left external iliac artery (arrow) inside. (C) Microscopic findings of the tumor. Multinucleated syncytiotrophoblast cells are growing over nest of cytotrophoblasts in a pelxiform pattern (H&E, ×100). (D) Immunoreactive for p63 immunostaining (p63, ×100). (E) The tumor cells are immunoreacitve for cytokeratin 7 (CK7, ×100). (F) The syncytiotrophoblast cells express β-human chorionic gonadotropin (β-hCG, ×100).

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