Document Detail

Incidental finding of placental choriocarcinoma after an uncomplicated term pregnancy: a case report with review of the literature.
MedLine Citation:
PMID:  20736774     Owner:  NLM     Status:  MEDLINE    
Choriocarcinoma is frequently preceded by a complete mole, ectopic pregnancy, nonmolar intrauterine abortion, and uncommonly by a partial mole. Choriocarcinoma coexisting with or after an otherwise "normal" pregnancy is extremely rare, with an estimated occurrence of 1 per 160,000 pregnancies. We here report a case of a placental choriocarcinoma with no metastases in a full-term intrauterine pregnancy. The patient is a 29-year-old gravida 2 para 1 female, who had an uncomplicated full-term vaginal delivery of a healthy 3030 g female infant. Her current pregnancy was uneventful, and past medical history was significant for an elective termination of pregnancy 2 years ago at 8 weeks of gestation. Routine examination of the placenta showed a gray-tan nodule, measuring 2 cm in the largest dimension, with a papillary cut surface. Microscopically, this nodule was composed of highly atypical cytotrophoblastic cells and multinucleated atypical syncytiotrophoblastic cells, which were positive for beta-human chorionic gonadotrophin by immunostaining. Extensive necrosis and multiple foci of hemorrhage were present. The overall morphologic and immunohistochemical features were diagnostic for choriocarcinoma. Further investigations, including a full body computed tomography scan, showed no lesions suspicious for metastases. The patient is currently asymptomatic and being followed-up with monthly beta-human chorionic gonadotrophin levels, the most recent one being negative. By reporting this case and reviewing the literature, we support the opinion of a recent similar case report that the incidence of placental choriocarcinoma may actually be higher than expected, as placental examination after a normal spontaneous delivery is not routinely performed at most of the institutions.
Karthik A Ganapathi; Tamera Paczos; Mary D George; Samuel Goodloe; Lucia L Balos; Frank Chen
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists     Volume:  29     ISSN:  1538-7151     ISO Abbreviation:  Int. J. Gynecol. Pathol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-25     Completed Date:  2010-12-10     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  8214845     Medline TA:  Int J Gynecol Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-8     Citation Subset:  IM    
Department of Pathology, Buffalo General Hospital, State University of New York at Buffalo, Buffalo, NY 14203, USA.
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MeSH Terms
Choriocarcinoma / metabolism,  pathology*
Incidental Findings
Term Birth
Uterine Neoplasms / metabolism,  pathology*
Comment In:
Int J Gynecol Pathol. 2011 Jul;30(4):364-5   [PMID:  21623208 ]

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