Ann Hepatobiliary Pancreat Surg.  2018 Feb;22(1):79-82. 10.14701/ahbps.2018.22.1.79.

Laparoscopic splenectomy for splenic rupture secondary to metastatic choriocarcinoma

• Aloysius T
• Shelat VG

• KMID: 2409084
• DOI: http://doi.org/10.14701/ahbps.2018.22.1.79

Abstract

Gestational choriocarcinoma is a rare and aggressive type of gestational trophoblastic neoplasia, which is characterized by early vascular invasion and widespread metastases. Choriocarcinoma metastasizes hematogenously, and bleeding from metastases is common. Splenic rupture from a metastatic tumour is exceedingly rare, with only a few reports. We report a case of a 41-year-old female presenting with acute abdomen and haemorrhagic shock secondary to splenic rupture from metastatic choriocarcinoma, which was managed with emergency laparoscopic splenectomy.

Keyword

Choriocarcinoma; Laparoscopy; Splenic rupture

MeSH Terms

Abdomen, Acute
Adult
Choriocarcinoma*
Emergencies
Female
Gestational Trophoblastic Disease
Hemorrhage
Humans
Laparoscopy
Neoplasm Metastasis
Pregnancy
Shock
Splenectomy*
Splenic Rupture*

Figure

• 

  Fig. 1 Splenectomy specimen showing splenic metastases with blood clot.

• 

  Fig. 2 Medium power view showing spleen affected by syncytiotrophoblasts and cytotrophoblasts suggestive of metastatic choriocarcinoma (Haematoxylin and Eosin stain, original magnification ×100).

• 

  Fig. 3 Endoscopic image showing duodenal lesion with intra luminal bleeding.

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