Ovarian Choriocarcinoma with Concurrent Metastases to the Spleen and Adrenal Glands: First Case Report

Abstract

Background: Pure nongestational ovarian choriocarcinoma (NGOC) is very rare tumor and has a poor prognosis. NGOC usually spreads to the lungs, liver, and brain. Metastases to the spleen and adrenal glands are rare, but simultaneous metastases to the spleen and adrenal glands have not been reported so far in the English literature. A case of NGOC with metastases to the splenic parenchyma and right adrenal gland is reported. Case: A 25-year-old woman presented with abdominal pain and was found to have a right ovarian mass and metastatic deposit in the right adrenal gland and spleen. She underwent optimal cytoreduction including excision of a right ovarian tumor, a partial splenectomy by radiofrequency ablation, and a right adrenalectomy. In view of her youth, her uterus and left adnexa were spared. Following these procedures, the patient received chemotherapy. Results: This patient is now in complete remission. Her β–human chorionic gonadotrophin levels post-treatment have reached normal levels. Conclusions: Aggressive surgery combined with chemotherapy may improve the prognosis of individuals with ovarian choriocarcinoma. Fertility-sparing surgery in such young individuals is possible, and may be psychologically beneficial. (J GYNECOL SURG 28:153)