Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3592-3598
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3592
Primary ovarian choriocarcinoma occurring in a postmenopausal woman: A case report
Guan-Lin Dai, Fu-Rong Tang, Dan-Qing Wang
Guan-Lin Dai, Fu-Rong Tang, Dan-Qing Wang, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Guan-Lin Dai, Fu-Rong Tang, Dan-Qing Wang, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, Sichuan Province, China
Author contributions: Dai GL contributed to manuscript writing and editing, and data collection; Tang FR contributed to data analysis; Wang DQ contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Supported by Project of Science and Technology Department of Sichuan Province, No. 2020YFS0131 and No. 2016FZ0081.
Informed consent statement: The patient provided written informed consent for the inclusion of her clinical and imaging details in the manuscript for publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dan-Qing Wang, PhD, Chief Physician, Doctor, Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, No. 20 the Third Section of South Renmin Road, Chengdu 610041, Sichuan Province, China. danqingwang@163.com
Received: January 4, 2023
Peer-review started: January 4, 2023
First decision: March 24, 2023
Revised: April 5, 2023
Accepted: April 21, 2023
Article in press: April 21, 2023
Published online: May 26, 2023
Processing time: 141 Days and 1.8 Hours
Abstract
BACKGROUND

Nongestational ovarian choriocarcinoma (NGOC) is a rare but aggressive neoplasm with limited sensitivity to chemotherapy and a very poor prognosis. Few cases of NGOC have been reported, and there is limited information regarding its clinical features, treatment protocols, or prognosis.

CASE SUMMARY

A postmenopausal woman in her 5th decade of life visited our clinic because of abnormal vaginal bleeding and an abdominal mass. Although she had been menopausal for more than eight years and her last abortion occurred nine years ago, she had an increased level of serum β-human chorionic gonadotropin (β-hCG). Thus, an ovarian neoplasm of trophoblastic origin was suspected, and exploratory laparotomy was performed. Based on the patient’s clinical history and the histopathological examination and immunohistochemistry results obtained postoperatively, we concluded that she most likely had primary NGOC. Cytoreductive surgery was performed in combination with adjuvant chemotherapy comprising bleomycin, etoposide, and cisplatin. Serum β-hCG levels decreased to normal after two cycles, and there was no evidence of recurrence after four cycles of chemotherapy.

CONCLUSION

Even in postmenopausal women, ovarian choriocarcinoma should be considered in the initial differential diagnosis for an adnexal mass.

Keywords: Postmenopausal; Choriocarcinoma; Ovarian neoplasm; Non-gestational; Trophoblastic; Case report

Core Tip: Ovarian choriocarcinoma (OC) typically affects teenagers and young women. However, this report presents a rare case of nongestational OC (NGOC) in a postmenopausal woman. Although DNA polymorphism analysis has been recommended for the confirmation of this disease, its applications are limited because of its high cost and technological deficiencies. Based on the long-time interval since her last pregnancy and menstruation and the histopathological examination and immunohistochemistry results, we suggested that the patient likely had primary NGOC. Early diagnosis and appropriate management are critical prognostic factors for this disease.