Primary Tubal Gestational Choriocarcinoma: A Case Report and Review of Literature

BackgroundChoriocarcinoma is a malignant germ cell tumor (GCT) arising from trophoblastic tissue and consisting of syncytiotrophoblasts, cytotrophoblasts and intermediate trophoblasts.AQ1 The two forms of choriocarcinoma are gestational and non-gestational, of which the former arises following a hydatidiform mole, normal pregnancy, or most commonly, spontaneous abortion, while the latter arises from pluripotent germ cells. They have very different biological activity and prognoses. Primary tubal choriocarcinoma is an extremely rare occurrence even in gestational women and usually follows a tubal ectopic. DiscussionThis article concerns a case of tubal choriocarcinoma developing in a 28-year-old woman. The woman presented with four months of amenorrhea. Ultrasound showed a heterogeneous solid-cystic mass arising from the left adnexa and extending up to the right adnexa abutting right ovary. Her serum human chorionic gonadotropin (beta-hCG) levels were 29,116 mIU/ml. The patient underwent urgent laparotomy with excision of adnexal mass in view of torsion. Histopathology revealed malignant cytotrophoblasts, syncytiotrophoblasts and intermediate trophoblasts with marked atypia and brisk mitosis, suggestive of tubal choriocarcinoma. Immunohistochemistry tests were positive for the hCG, GATA3, Ki 67, CK 7 and negative for CD30, supporting the diagnosis of choriocarcinoma. Follow-up radiology did not reveal any metastatic lesions, and patient was started on chemotherapy. ConclusionIn this report, we summarize the clinical, histomorphological and immunohistochemistry findings of tubal choriocarcinoma.