Metastatic Choriocarcinoma in Postmenopausal Woman: A Case report

Document Type : Case report

Authors

1 Professor of Obstetrics & Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident in Obstetrics & Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:Gestational trophoblastic neoplasia (GTN) usually occurs during women’s reproductiveages and it is very unusual in postmenopausal women. The aim of this study is to present a case of GTN in a postmenopausal woman.
 
Case Report: A 60-year-old woman with history of vaginal bleeding and a mass lesion was admitted to Ghaem hospital affiliated to Mashhad university of medical sciences. She afterwards underwent surgical biopsy of vaginal mass and histological evaluation revealed metastatic choriocharcinoma. Investigation for extention of metastases performed and the final diagnosis was a stage IIIc choricaricnoma. Patient received EMA-CO regimen chemotherapy (Etoposide, Methotrexate, Actinomycine, Cyclophosphamide, Vincristin) and after seven courses of chemotherapy she experienced a complete relief.
 
Conclusion: Physicians should not ignore the possibility of GTN in different ages with a variety of presentations.

Keywords


1. Bazinet R, Ibrahim AB, Campbeil JS. Choriocarcinoma in a postmenopausal nulligravida. Can Med Assoc J
1970; 102(2):150-1.
2. Massenkeil G, Cromback G, Dominik S, Bruyne F, Nitz U, Krussel J, et al. Metastatic choriocarcinoma in a
postmenopausal woman. Gynecol Oncol 1996;61(3):432-7.
3. Ramondetta LM, Silva EG, Levenback CF, Burke TW. Mixed choriocarcinoma in postmenopausal patient.
Int J Gynecol Cancer 2002;12(3):312-6.
4. Lok CA, Zürcher AF, van der Velden J. A case of hydatiform mole in a 56- year-old woman.
Int J Gynecol Cancer 2005;15(1):163-6.
5. Jequier A, Winterton WR. Diagnostic problems of trophoblastic disease in women aged 50 or more.
Obstet Gynecol 1973;42:378-97.
6. Garcia M, Romanguera RL, Gomez-Fenandez G. A hydatidiform mole in a post menopausal woman:
a case report and review of the literature. Arch Pathol Lab Med 2004;128:1039-43.
7. Matsui H, Seki K, Sekiya S, Takamizawa H. Reproductive status in GTD treated with Etoposide.
J Reprod Med 1997;42:104-10.
8. Tsukamoto N, Iwasaka T, Kashimura Y, Uchino H, Kashimura M, Matsuyama T. Gestational trophoblastic
disease in women aged 50 or more. Gynecol Oncol 1985;20(1):53-61.
9. Miletić T, Aberle N, Mikulandra F, Karelović D, Zakanj Z, Banović I, et al. Perinatal outcome of
pregnancies in women aged 40 and over. Coll Antropol 2002;26(1):251-8.
10. Kohorn El. The new FIGO 2000 staging and risk factor scoring for gestational trophoblastic disease
description and critical assessment. Int J Gyencol Cancer 2001;11(1):73-7.
11. Hirabayashi K, Yasuda M, Osamura RY, Hirasawa T, Murakami M. Ovarian nongestational
choriocarcinoma mixed with various epithelial malignancies in association with endometriosis.
Gynecol Oncol 2006;102(1):111-7.
12. Mukherjee U, Thakur V, Katiyar D, Goyal HK, Pendharkar D. Uterine choriocarcinoma in a
postmenopausal women. Med Oncol 2006;23(2):301-3.
13. Abike F, Temizkan O, Payasli A, Avsar F, Baspinar S. Postmenopausal complete hydatidiform mole:
a case report. Maturitas 2008;59(1):95-8.