Puerperal Choriocarcinoma After Normal Term Pregnancy: Surgery Role in Selected Cases

Abstract

Choriocarcinoma is a malignant neoplasm that classically displays biphasic morphology (syncytiotrophoblasts, cytotrophoblasts and trophoblastic cells). The incidence after term pregnancy is unusual, being diagnosed in most of them because of symptoms due to metastases. We report a case of puerperal choriocarcinoma after a normal uncomplicated pregnancy. After the diagnosis, it was classified as FIGO Stage III malignant gestational trophoblastic neoplasia and high-risk choriocarcinoma. The patient began multiagent systemic chemotherapy biweekly (EMA-CO). Although her tumor marker was normalized after the 3rd cycle, the full-body scan showed a diminishing of the uterine mass but persistent lung metastases. The patient underwent an uncomplicated laparotomy hysterectomy and bilateral salpingectomy procedure. She completed 6 cycles of EMA-CO in total, after which lung lesions disappeared. She remains disease-free 12 months after diagnosis.