Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Choriocarcinoma in a 73-year-old woman: a case report and review of the literature | Desai et al. Journal of Medical Case Reports 2010 4 379 http content 4 1 379 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Choriocarcinoma in a 73-year-old woman a case report and review of the literature 1 2 2 2 -2 Nisarg R Desai Shilpi Gupta Rabih Said Priyal Desai Qun Dai Abstract Introduction Choriocarcinoma is a highly malignant tumor of trophoblastic origin. Most cases present within one year of the antecedent pregnancy molar or non-molar . However very rarely choriocarcinoma can develop from germ cells or from dedifferentiation of endometrial carcinoma into choriocarcinoma. This article concerns a case of choriocarcinoma developing 38 years after the patient s last pregnancy and 23 years after menopause. Case presentation A 73-year-old African-American woman presented with a three-week history of vaginal bleeding. A vaginal mass was seen on pelvic examination. Ultrasonography showed a thickened complex endometrial echo. Her p-human chorionic gonadotrophin level was found to be elevated 2 704 040 mIU mL . Vaginal and uterine biopsies were suggestive of choriocarcinoma. Immunohistochemistry tests were positive for p-human chorionic gonadotrophin as well as cytokeratin and negative for octamer binding transcription factor 3 4 and a-fetoprotein supporting the diagnosis of choriocarcinoma. A combination of etoposide methotrexate and dactinomycin followed by cyclophosphamide and vincristine the so-called EMA CO regimen was initiated. After seven cycles of chemotherapy her p-human chorionic gonadotrophin level dropped below 5 mIU mL. Our patient is being followed up at our oncology institute. Conclusions We report an extremely rare case of choriocarcinoma arising 23 years after menopause. A postmenopausal woman presenting with vaginal bleed from a mass and p-human chorionic gonadotrophin elevation should be evaluated by immunohistochemical analysis to rule out the possibilities of a germ cell origin of the tumor or .
