A Case of Metastatic Vulvar Choriocarcinoma Misdiagnosed as Vulvar Abscess: A Case Report

被引:0
作者
Mrema, Alita [1 ,2 ]
Kiwia, Prudence H. [1 ]
Shaban, Shaban J. [1 ,2 ]
Mohamed, Anwar Z. [3 ]
Abdallah, Latifa Rajab [4 ]
Kiaratu, Rajabu [1 ]
Mahoyogo, John [1 ]
Chuwa, Agapiti [5 ]
Mvunta, David H. [3 ,6 ,7 ]
机构
[1] Ocean Rd Canc Inst, Dept Clin Oncol, Barack Obama Dr,POB 3592, Dar Es Salaam, Tanzania
[2] Muhimbili Univ Hlth & Allied Sci, Dept Clin Oncol, 9 United Nations Rd,Upanga West,POB 65001, Dar Es Salaam, Tanzania
[3] Ocean Rd Canc Inst ORCI, Dept Surg Oncol, POB 3592 Barrack Obama Dr, Dar Es Salaam, Tanzania
[4] Ocean Rd Canc Inst, Radiol & Imaging Sect, Barack Obama Dr,POB 3592, Dar Es Salaam, Tanzania
[5] Univ Dar es Salaam, Mbeya Coll Hlth & Allied Sci, Dept Physiol, POB 608, Dar Es Salaam, Tanzania
[6] Muhimbili Univ Hlth & Allied Sci, Dept Obstet & Gynecol, 9 United Nations Rd,POB 65001, Dar Es Salaam, Tanzania
[7] St Joseph Coll Hlth & Allied Sci, Dept Obstet & Gynecol, POB 11007, Dar Es Salaam, Tanzania
关键词
case report; choriocarcinoma; gestational trophoblastic disease; gestational trophoblastic neoplasia; GESTATIONAL TROPHOBLASTIC DISEASE;
D O I
10.1155/2024/9918452
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Background: Metastatic vulvar choriocarcinoma, a rare ectopic gestational trophoblastic neoplasia (GTN), often presents a diagnostic challenge due to its mimicry of other conditions, particularly in resource-limited settings. Its primary symptom is abnormal vaginal bleeding without a clear cause. Consequently, diagnosing and managing it poses difficulties for many low-resource health facilities, as evidenced by the current case. Case Presentation: We present the case of a 25-year-old, P2+2+2L2, who had a large painless, bleeding vulva mass for nearly 5 months. This followed a spontaneous abortion the month prior. The mass gradually increased in size and was accompanied by fever, pus discharge, and weight loss. Despite being treated at multiple health facilities for a vulvar abscess, there was no improvement. A diagnosis was finally made at a tertiary facility where elevated quantitative serum beta-human chorionic gonadotropin (hCG) (beta-hCG) was noted. Due to uncontrollable vulva bleeding, she was referred to another tertiary facility for emergency radiotherapy. Following stabilization, chemotherapy was administered using the EMA-CO protocol. Conclusion: The report highlights the difficulty in diagnosing vulvar choriocarcinoma, underscoring the importance of a high index of suspicion. Clinical tests such as serum (beta-hCG) and imaging studies are crucial for diagnosis. In resource-limited settings, a simple strip-based urine pregnancy test with serial dilutions can be sufficient for diagnosing and managing vulvar choriocarcinoma.
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页数:6
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