A successfully treated case of primary tubal choriocarcinoma coexistent with viable intrauterine pregnancy

Abstract

BACKGROUND: Choriocarcinoma of the fallopian tube is extremely rare as is choriocarcinoma with a viable pregnancy. We present an unusual case of prima gravida at 33 weeks gestation that was diagnosed as having tubal choriocarcinoma which was successfully treated by chemotherapy. CASE: A 31-year-old prima gravida at 32(+3) weeks gestation was admitted complaining of dyspnea and blood tinged sputum. Suspecting a left adnexal malignant tumor with pulmonary metastasis, delivery of the baby for optimal treatment of the mother's tumor was planned. Cesarean delivery was performed because of induction failure. Tumorectomy with left salpingectomy and infracolic omentectomy was performed for a left tubal tumor. Microscopic findings revealed choriocarcinoma with extensive hemorrhage. Its FIGO stage was III and its WHO prognostic score 12, representing high risk. After 4 cycles of chemotherapy, serum beta-hCG level fell to the normal range. The patient and her baby remain disease-free 16 months after disease diagnosis. CONCLUSION: This is the first reported case of tubal choriocarcinoma coexistent with a viable pregnancy, in which the baby survived and the mother was successfully treated by chemotherapy.