Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3867
Peer-review started: March 20, 2020
First decision: July 25, 2020
Revised: August 2, 2020
Accepted: August 15, 2020
Article in press: August 15, 2020
Published online: September 6, 2020
Processing time: 168 Days and 4.9 Hours
Although choriocarcinoma is thought to be a malignancy curable by chemotherapy, there remain difficult and challenging problems in cases with high prognostic scores or extensive metastases, for which the treatment is limited. Particularly, chemotherapy in combination with other treatments offers promising therapeutic potential for these cases.
We present the case of a 40-year-old female patient who suffered from life-threatening hemoptysis and paraplegia due to choriocarcinoma with pulmonary, hepatic and spinal metastases. The patient successfully recovered after multidisciplinary treatment consisting of 21 cycles of intravenous chemotherapy, radiofrequency ablation of multiple hepatic metastases, intensity-modulated radiation therapy for spinal metastases and routine physiotherapy. To our knowledge, it is the first reported case of recovery from pulmonary, hepatic and spinal metastases of choriocarcinoma with no specific primary site. Moreover, this is the first reported clinical attempt on 5-d actinomycin D as primary chemotherapy in ultrahigh-risk gestational trophoblastic neoplasia.
The case supports the opinion that the individualized treatment of choriocarcinoma by a multidisciplinary approach can accomplish optimal therapeutic effects.
Core tip: In this case report, we discuss a case of choriocarcinoma in a patient who presented with life-threatening hemoptysis and paraplegia due to metastases. We review her clinical manifestation and treatment, subsequently discussing the multidisciplinary treatment approach used to successfully treat this patient. Our study provides a new treatment modality for metastatic choriocarcinoma.