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Case Reports

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Intraplacental choriocarcinoma metastasizing to the maternal lung

  • D. Landau1
  • E. Maor2
  • E. Maymon3
  • A. Rabinovich4
  • B. Piura4,*,

1Department of Neonatology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

2Institute of Pathology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

3Unit of Feta-Maternal Medicine, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

4Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

DOI: 10.12892/ejgo20060129 Vol.27,Issue 1,January 2006 pp.29-32

Published: 10 January 2006

*Corresponding Author(s): B. Piura E-mail:

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Abstract

Background: Although normal pregnancy is the precursor of 25% of cases of maternal choriocarcinoma, intraplacental choriocarcinoma in an otherwise normal placenta associated with viable pregnancy has rarely been reported.

Case: Examination of the placenta after delivery of a pale and small-for-date infant at term revealed intraplacental choriocarcinoma. There was no evidence of metastatic disease in the mother or child, but the mother exhibited postpartum rising levels of beta-HCG. The mother refused chemotherapy and disappeared from follow-up. Nine months later, she presented with metastatic choriocarcinoma of the lung. Eleven courses of the multi-drug EMA CO regimen effected a decrease of beta-HCG to normal and disappearance of lung metastases. To date, 28 months after the end of chemotherapy, the patient is alive and without evidence of gestational trophoblastic disease. Moreover, since then she has given birth to an additional two children.

Conclusions: This case is an example of natural disease progression of intraplacental choriocarcinoma metastasizing to the mother. Furthermore, it supports common knowledge that the multi-drug EMA CO regimen is effective treatment in poor prognosis metastatic choriocarcinoma.

Keywords

Placenta; Choriocarcinoma; Trophoblast; Chemotherapy; EMA CO regimen

Cite and Share

D. Landau,E. Maor,E. Maymon,A. Rabinovich,B. Piura. Intraplacental choriocarcinoma metastasizing to the maternal lung. European Journal of Gynaecological Oncology. 2006. 27(1);29-32.

URL:

https://www.ejgo.net/articles/10.12892/ejgo20060129

References

[1] Jacques S.M., Qureshi F., Doss B.J., Munkarah A.: "Intraplacental choriocarcinoma associated with viable pregnancy: pathologic features and implication for the mother and infant". Pediatr. Dev. Pathol., 1998, 1, 380.

[2] Fox H., Laurini R.N.: "Intraplacental choriocarcinoma: a report of two cases". J. Clin. Pathol., 1988, 41, 1085.

[3] Barghorn A., Bannwart F., Stallmach T.: "Incidental choriocarcinoma confined to a near-term placenta". Virchows Arch., 1998, 433, 89.

[4] Langston C., Kaplan C., Macpherson T., Manci E., Peevy K., Clark B. et al.: "Practice guideline for examination of the placenta developed by the Placental Pathology Practice Guideline Development Task Force of the College of American Pathologists" Arch. Pathol. Lab. Med., 1997, 121, 449.

[5] Duleba A.J., Miller D., Taylor G., Effer S.: "Expectant management of choriocarcinoma limited to placenta". Gynecol. Oneal., 1992, 44, 277.

[6] Santamaria M., Benirschke K., Carpenter P.M., Baldwin VJ., Pritchard J.A.: "Transplacental hemorrhage associated with placental neoplasms". Pediatr. Pathol., 1987, 7, 601.

[7] Takai N., Miyazaki T., Yoshimatsu J., Moriuchi A., Miyakawa I. "Intraplacental choriocarcinoma with fetomaternal transfusion". Pathol. Int., 2000, 50, 258.

[8] Lee K.W., Ho L.C.: "A case of massive fetomaternal haemorrhage at term associated with choriocarcinoma". Aust. N.Z.J. Obstet Gynecol., 1999, 39, 274.

[9] Hallam L.A., McLaren K.M., el-Jabbour J.N., Helm C.W., Smart G.E.: "Intraplacental choriocarcinoma: a case report". Placenta, 1990, 11, 247.

[10] Driscoll S.G.: "Choriocarcinoma: an "incidental finding" withm a term placenta". Obstet. Gynecol., 1963, 21, 96.

[11] Lele S.M., Crowder S.E., Grafe M.R.: "Asymptomatic intraplacental choriocarcinoma diagnosed on routine placental examination". J. Perinatal., 1999, 19, 244.

[12] Tidy J.A., Rustin G.J., Newlands E.S., Foskett M., Fuller S., Short D., Rowden P.: "Presentation and management of choriocarcinoma after nonmolar pregnancy". Br. J. Obstet. Gynecol., 1995, 102, 715.

[13] Tsukamoto N., Natsumura M., Matsukuma K., Kamura T., Baba K.: "Choriocarcinoma in mother and fetus". Gynecol. Oncol., 1986, 24, 113.

[14] Flam F., Lundstrom V., Silfversward C.: "Choriocarcinoma in mother and child: case report". Br. J. Obstet. Gynecol., 1989, 96,241.

[15] Kruseman A.C., van Lent M., Blom A.H., Lauw G.P.: "Choriocarcinoma in mother and child, identified by immunoenzyme histochemistry". Am. J. Clin. Pathol., 1977, 67, 279.

[16] Tsukamoto N., Kashimura Y., Sano M., Saito T., Kanda S., Taki I.: "Choriocarcinoma occurring within the normal placenta with breast metastasis". Gynecol. Oncol., 1981, 11, 348.

[17] Kishkurno S., Ishida A., Takahashi Y., Arai H., Nakajima W., Abe T., Takada G.: "A case of neonatal choriocarcinoma". Am. J. Perinatol., 1997, 14, 79.

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