Case ReportsOvarian nongestational choriocarcinoma mixed with various epithelial malignancies in association with endometriosis
Introduction
Most cases of choriocarcinoma (CC) occur in the uterine body in association with an antecedent pregnancy. The diagnosis of CC can be predicted by the measurement of serum or urinary human chorionic gonadotropin (hCG) prior to an operation. Ovarian nongestational CC is occasionally encountered as a part of mixed germ cell tumors [1]. However, only 30 cases of the pure form of nongestational ovarian CC have been reported. Coexistence of ovarian CC with surface epithelial tumors instead of germ cell tumors is very rare. There have been only four reported cases of ovarian CC coexisting with epithelial tumors, such as poorly differentiated carcinoma [2], mucinous cystadenocarcinoma [3], and mucinous cystadenoma [2], [4]. Herein, we report a case of nongestational ovarian CC in conjunction with mixed epithelial carcinomas; the first reported case of an admixture of endometrioid, clear cell, and small cell carcinoma with choriocarcinoma in a background of endometriosis. In this study, the clinical and pathological features of this condition have been discussed.
Section snippets
Case report
A 50-year-old postmenopausal woman, gravida 0, was admitted to our hospital with abdominal pain and distention. The past medical history of the patient revealed that the patient had undergone a left salpingoophorectomy because of ovarian endometriosis at the age of 25 years. At the age of 47 years, she was admitted to our hospital with abdominal pain. Magnetic resonance imaging (MRI) revealed a 10 × 10 × 6.5 cm-sized cystic mass without a solid part in the pelvic cavity. Since the mass was
Discussion
Ovarian nongestational CC is occasionally shown to be mixed with other germ cell tumors [1]. Choriocarcinomatous differentiation rarely occurs in carcinomas of various origins, such as the stomach, colon, liver, gallbladder, breast, urinary bladder, prostate, uterus, and ovary [2]. The prognosis of these tumors is unfavorable because of rapid tumor growth with metastatic disease and resistance to usual chemotherapeutic regimens [3]. The most plausible explanation for the association of
References (11)
- et al.
Nongestational pure ovarian choriocarcinoma with contralateral teratoma
Gynecol. Oncol.
(2001) - et al.
Histologic transformation of benign endometriosis to early epithelial ovarian cancer
Gynecol. Oncol.
(1996) Chemotherapy for small cell lung cancer
Semin. Oncol.
(2003)- et al.
Malignant mixed germ cell tumors of the ovary. A clinical and pathologic analysis of 30 cases
Obstet. Gynecol.
(1976) - et al.
Ovarian carcinomas with choriocarcinomatous differentiation
Cancer
(1993)
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