Ectopic Gestational Trophoblastic Disease

Abstract

Abstract

Background: Gestational choriocarcinoma associated with ectopic pregnancy is an extremely rare event with a reported incidence of 1.5/1,000,000 births. This article reports a rare case of gestational choriocarcinoma associated with an ectopic pregnancy. Case: An 18-year-old woman, gravida 3, para 0+2, was admitted to the emergency gynecology assessment unit complaining of abdominal pain. Her presentation was the same as for a conventional ectopic pregnancy. Her transvaginal ultrasound images were compatible with a tubal ectopic pregnancy. A left salpingectomy was performed. The histopathologic evaluation reported the lesion as a primary tubal choriocarcinoma. The patient was referred to a tertiary-care center for treatment and follow-up. Results: This patient had a good recovery and follow-up has been ongoing for the last 9 months, as of this writing. Her β–human chorionic gonadotropin level dropped to normal at 7 weeks postsurgery, and she has no indications for chemotherapy. This patient's general physical and neurologic assessment results have remained normal. Her prognosis is excellent. Conclusions: Ectopic gestational trophoblastic disease is rare and is still overdiagnosed. The presentation is the same as that of a normal ectopic pregnancy. Expert review of the patient's histopathology should be performed. Conventional chemotherapy for gestational choriocarcinoma is effective. The prognosis for these cases is excellent. (J GYNECOL SURG 30:360)