Abstract
Background: Choriocarcinoma is a rare clinical condition, and its diagnosis may be difficult, especially in resource-limited settings. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy. She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. Conclusion: The diagnosis of choriocarcinoma may be difficult especially when it develops ab initio without preceding abortion, molar or term pregnancy. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring.
Highlights
According to the World Health Organization Science Group in 1983 [1] on histopathological and clinical terminology, gestational choriocarcinoma is a carcinoma arising from the trophoblastic epithelium that shows both cytotrophoblastic and syncytiotrophoblastic element
It may arise from conceptions that give rise to a live birth, a still birth, and abortion at any stage, an ectopic pregnancy or a hydatidiform mole, or it may arise from ab initio
Gestational trophoblastic diseases (GTD) comprise a variety of biologically interrelated conditions which form a clinical spectrum consisting of four distinct clinical pathological entities namely, molar pregnancy, invasive mole, placental site trophoblastic tumours, and choriocarcinoma [2,3,4]
Summary
According to the World Health Organization Science Group in 1983 [1] on histopathological and clinical terminology, gestational choriocarcinoma is a carcinoma arising from the trophoblastic epithelium that shows both cytotrophoblastic and syncytiotrophoblastic element. Case Presentation: A 38-year old para 2 woman is with a 4-month history of intractable vaginal bleeding and offensive vaginal discharge, but without antecedent pregnancy She had previously been managed at various tertiary medical institutions where several pelvic ultrasound scans and even histology of endometrial curette could not clinch the diagnosis. The diagnosis of choriocarcinoma was made by a serial strip-based pregnancy testing, which was still positive at 1:200 dilutions. She was treated with chemotherapy involving Adriamycin, Cyclophosphamide, Methotrexate and Folinic acid. In settings where serum hCG assay may be not available, the simple strip-based pregnancy test in dilution could be helpful in its diagnosis and treatment monitoring
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