Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature
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(2020) 18:245
CASE REPORT
Open Access
Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature Shengjie Xu†, Xiaohong Song†, Chengjuan Jin* and Yanli Li*
Abstract Background: Tubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis. Case presentation: This report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence. Conclusions: Tubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma. Keywords: Tubal choriocarcinoma, Ectopic pregnancy, Histopathology, Immunohistochemistry, Chemotherapy
Background Tubal choriocarcinoma is a kind of highly malignant trophoblastic tumor, which can be either gestational or non-gestational in origin. According to reports, the incidence of tubal choriocarcinoma is about 1.5/106 [1]. The age of onset ranges from 16 to 56 years with an average of 33 years. Non-gestational tubal choriocarcinoma is extremely rare, and gestational tubal choriocarcinoma tends to occur on the basis of tubal pregnancy. In few cases, gestational tubal choriocarcinoma occurs after
* Correspondence: [email protected]; [email protected] † Shengjie Xu and Xiaohong Song contributed equally to this work. Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 100# Haining Rd, Shanghai 200080, China
in vitro fertilization and fallopian tube sterilization, and even simultaneously with an intrauterine pregnancy [2]. Tubal choriocarcinoma can be easily misdiagnosed as ectopic pregnancy due to its main clinical manifestations similar to those of ectopic pregnancy, such as amenorrhea, irregular vaginal bleeding, abdominal pain, and elevated serum β hCG. Delayed treatment or even tumor metastasis may be caused if not diagnosed and intervened in time. Therefore, how to make a differential diagnosis and better understand and treat such diseases has attracted more and more attention from obstetricians and gynecologists in recent years. This article summarizes and analyzes the epidemiology, disease characterist
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