FIGO stage IV gestational choriocarcinoma misdiagnosed as pulmonary tuberculosis: A case report

Yang,Lingyun; Xu,Pang; Xi,Mingrong; Wang,Hongjing

doi:10.3892/ol.2015.3443

FIGO stage IV gestational choriocarcinoma misdiagnosed as pulmonary tuberculosis: A case report

Authors:
- Lingyun Yang
- Pang Xu
- Mingrong Xi
- Hongjing Wang
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Affiliations: Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
Published online on: July 1, 2015 https://doi.org/10.3892/ol.2015.3443
Pages: 1924-1926

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Abstract

Choriocarcinoma is a rare, highly malignant neoplasm, which may occur during or following any type of pregnancy. This tumor often demonstrates rapid hematogenous spread to multiple organs, and is associated with high human chorionic gonadotropin (HCG) levels and a good response to chemotherapy. In the present study, the case of a 29‑year‑old female with distant metastatic choriocarcinoma [International Federation of Gynecology and Obstetrics (FIGO) stage IV; World Health Organization score, 15], who was misdiagnosed with pulmonary tuberculosis at a local hospital is presented. The major failure in the diagnosis of this case was that the patient's serum β‑HCG levels were ignored initially. However, the patient received combined treatment with systematic multi‑agent chemotherapy, whole‑brain radiation therapy and gross total resection of the brain lesion at West China Second Hospital, and achieved complete remission. In conclusion, the accurate and prompt diagnosis of choriocarcinoma is crucial for a good outcome. Furthermore, in young female patients exhibiting symptoms such as pulmonary bleeding or neurological disturbances following a hydatidiform mole or a normal pregnancy, even in the absence of abnormal uterine bleeding, serum β‑HCG levels must be analyzed and a diagnosis of choriocarcinoma must be considered.

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1	May T, Goldstein DP and Berkowitz RS: Current chemotherapeutic management of patients with gestational trophoblastic neoplasia. Chemother Res Pract. 2011:8062562011.PubMed/NCBI
2	Berkowitz RS and Goldstein DP: Chorionic tumors. N Engl J Med. 335:1740–1748. 1996. View Article : Google Scholar : PubMed/NCBI
3	Monchek R and Wiedaseck S: Gestational trophoblastic disease: An overview. J Midwifery Womens Health. 57:255–259. 2012. View Article : Google Scholar : PubMed/NCBI
4	Berkowitz RS and Goldstein DP: Current advances in the management of gestational trophoblastic disease. Gynecol Oncol. 128:3–5. 2013. View Article : Google Scholar : PubMed/NCBI
5	Oranratanaphan S and Lertkhachonsuk R: Treatment of extremely high risk and resistant gestational trophoblastic neoplasia patients in King Chulalongkorn Memorial Hospital. Asian Pac J Cancer Prev. 15:925–928. 2014. View Article : Google Scholar : PubMed/NCBI
6	Han SN, Amant F, Leunen K, Devi UK, Neven P, Berteloot P and Vergote I: Treatment of high-risk gestational trophoblastic neoplasia with weekly high-dose methotrexate-etoposide. Gynecol Oncol. 127:47–50. 2012. View Article : Google Scholar : PubMed/NCBI
7	FIGO Committee on Gynecologic Oncology, . Current FIGO staging for cancer of the vagina, fallopian tube, ovary and gestational trophoblastic neoplasia. Int J Gynaecol Obstet. 105:3–4. 2009. View Article : Google Scholar : PubMed/NCBI
8	Shrivastava S, Kataki AC, Barmon D, et al: Gestational trophoblastic neoplasia: A 6 year retrospective study. South Asian J Cancer. 3:33–37. 2014. View Article : Google Scholar : PubMed/NCBI
9	Cole LA, Khanlian SA, Muller CY, Giddings A, Kohorn E and Berkowitz R: Gestational trophoblastic diseases: 3. Human chorionic gonadotropin-free beta-subunit, a reliable marker of placental site trophoblastic tumors. Gynecol Oncol. 102:160–164. 2006. View Article : Google Scholar : PubMed/NCBI
10	Morgan JM and Lurain JR: Gestational trophoblastic neoplasia: An update. Curr Oncol Rep. 10:497–504. 2008. View Article : Google Scholar : PubMed/NCBI
11	Sierra-Bergua B, Sánchez-Marteles M, Cabrerizo-García JL and Sanjoaquin-Conde I: Choriocarcinoma with pulmonary and cerebral metastases. Singapore Med J. 49:e286–e288. 2008.PubMed/NCBI
12	Soper JT, Mutch DG and Schink JCAmerican College of Obstetricians and Gynecologists: Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53. Gynecol Oncol. 93:575–585. 2004. View Article : Google Scholar : PubMed/NCBI
13	Zhao Y, Zhang W and Duan W: Management of gestational trophoblastic neoplasia with 5-fluorouracil and actinomycin D in northern China. J Reprod Med. 54:88–94. 2009.PubMed/NCBI
14	Manopunya M and Suprasert P: Resistant gestational trophoblastic neoplasia patients treated with 5-fluorouracil plus actinomycin D. Asian Pac J Cancer Prev. 13:387–390. 2012. View Article : Google Scholar : PubMed/NCBI
15	Bolis G, Bonazzi C, Landoni F, Mangili G, Vergadoro F, Zanaboni F and Mangioni C: EMA/CO regimen in high-risk gestational trophoblastic tumor (GTT). Gynecol Oncol. 31:439–444. 1988. View Article : Google Scholar : PubMed/NCBI
16	Turan T, Karacay O, Tulunay G, Boran N, Koc S, Bozok S and Kose MF: Results with EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) chemotherapy in gestational trophoblastic neoplasia. Int J Gynecol Cancer. 16:1432–1438. 2006. View Article : Google Scholar : PubMed/NCBI
17	Baertschi E, Notter M, Mironov A, Wernli M and Bargetzi MJ: Cerebral metastasis in choriocarcinoma a case report. Praxis. 92:763–768. 2003. View Article : Google Scholar : PubMed/NCBI
18	Milenković V, Lazović B, Mirković L, Grujicić D and Sparić R: Brain metastases of choriocarcinoma-a report on two cases. Vojnosanit Pregl. 70:968–971. 2013. View Article : Google Scholar : PubMed/NCBI
19	Milenković V, Lazović B, Mačvanski M, Jeremić K and Hrgović Z: Clinical outcome of a FIGO stage IV gestational choriocarcinoma. Case Rep Oncol. 6:504–507. 2013. View Article : Google Scholar : PubMed/NCBI