Obstet Gynecol Sci.  2014 Jul;57(4):330-333. 10.5468/ogs.2014.57.4.330.

Primary ovarian choriocarcinoma mimicking ectopic pregnancy

• Heo EJ
• Choi CH
• Park JM
• Lee JW
• Bae DS
• Kim BG

• KMID: 1841547
• DOI: http://doi.org/10.5468/ogs.2014.57.4.330

Abstract

Nongestational ovarian choriocarcinoma is an exceedingly rare and highly aggressive tumor. Although early diagnosis and timely initiation of therapy is important, it is difficult in reproductive aged patients because of the frequent elevation of human chorionic gonadotropin. We report a primarily nongestational ovarian choriocarcinoma in a 12-year-old virgin female. Initial diagnosis based on abdominopelvic computed tomography and pelvis magnetic resonance imaging was ectopic pregnancy with hemoperitoneum. A diagnostic laparoscopy of the ovarian tumor revealed choriocarcinoma. Unilateral salpingo-oophorectomy and omental sampling revealed surgical stage of IA. Six courses of adjuvant combination chemotherapy (bleomycin, etoposide, and cisplatin) followed surgery.

Keyword

Choriocarcinoma; Laparoscopy; Nongestational; Ovary

MeSH Terms

Child
Choriocarcinoma*
Chorionic Gonadotropin
Diagnosis
Drug Therapy, Combination
Early Diagnosis
Etoposide
Female
Hemoperitoneum
Humans
Laparoscopy
Magnetic Resonance Imaging
Ovary
Pelvis
Pregnancy
Pregnancy, Ectopic*
Chorionic Gonadotropin
Etoposide

Figure

• 

  Fig. 1 (A) Pelvis magnetic resonance imaging T2 image shows an approximately 2.8 cm sized hemorrhagic cystic lesion with enhancing portion and enhancing salpinx in the left ovary. (B) Laparoscopic views show a cystic and solid mass about 5×3 cm in size.

• 

  Fig. 2 (A) Gross appearance of the ovarian tumor. The cut surface shows papillary and solid portion with focal hemorrhage. (B) Microscopic finding of the choriocarcinoma shows a biphasic arrangement of cytotrophoblasts and syncytiotrophoblasts (H&E stain, ×200). (C) The choriocarcinoma component shows diffuse strong reactivity with beta-human chorionic gonadotropin by immunohistochemistry (×100). (D) The dysgerminoma component shows reactivity with octamer transcription factor 3/4 by immunohistochemistry (×200).

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