Cervical Choriocarcinoma in a Patient with no Previous History of Pregnancy and Histopathological Diagnosis: A Case Report
Jiao Shen*, Ayako Hosoi, Fujihiro Oka, Yuko Yano, Koji Hatta, Takanori Takayama, Kana Yoshimi, Kimiaki Ozaki, Noriatsu Saeki, Namiko Yada-Hashimoto
Choriocarcinomas are considered to be the most malignant gestational trophoblastic cancers. This neoplasia might occur due to a malignant transformation following molar pregnancies, abortions, or normal or ectopic pregnancies. Primary cervical choriocarcinomas are particularly rare conditions. In the present study, we report the case of cervical choriocarcinoma in a 43-year-old woman without previous pregnancy history. She was transferred to our hospital and presented with profuse and abnormal vaginal bleeding. Transvaginal ultrasound scan identified a 5 cm cervical mass, from which a biopsy sample was collected. Rapid pathologic findings suggested the tissue in the mass to be villi, but not adenocarcinoma or squamous cell carcinoma. Serum β-human chorionic gonadotropin (β- hCG) concentration was found to 71520 mIU/mL. These results indicated the possibility of a cervical pregnancy or a gestational trophoblastic disease. Subsequently, a total hysterectomy was performed due to the life-threating bleeding condition. The postoperative diagnosis was stage I cervical choriocarcinoma. Chemotherapy was administered due to the elevated risk of recurrence according to the international federation of gynecology and obstetrics (FIGO) risk scoring system. Taking this case into consideration, cervical choriocarcinomas should be included in the differential diagnosis of irregular vaginal bleeding, augmented β-hCG levels, even in cases of negative history for previous of pregnancy.