Brunner J, Högberg T, Malmström H, Simonsen E
Department of Gynecologic Oncology, University Hospital, Linköping, Sweden.
Eur J Gynaecol Oncol. 1991;12(5):395-8.
A case is presented of extragenital abdominal choriocarcinoma without uterine lesion in a postmenopausal woman. Nineteen years after her antecedent pregnancy, a legal abortion, and thirteen years after her menopause, the patient was admitted to the hospital because of intermittent abdominal pain. Explorative laparotomy revealed a large tumour mass in the greater omentum, mesosigmoideum, peritoneal implants and metastatic growth to the serosal lining of the uterus and the wall of the stomach. Cytoreductive surgery was performed. The histopathological report showed an extrauterine, nongonadal pure choriocarcinoma. Immunoperoxidase stain was strongly positive for hCG and a raised serum beta-hCG level preoperatively confirmed the diagnosis. A polychemotherapy regimen was administered. However, after six months the beta-hCG levels increased rapidly. Liver, lung and mediastinal metastases were diagnosed. The patient's condition rapidly deteriorated and she expired one month later. The post mortem examination showed a far advanced extragonadal pure choriocarcinoma without any obvious primary origin. The implications for a possible origin of extragonadal nongestational choriocarcinoma are briefly discussed.
本文报告一例绝经后女性发生的非生殖器腹部绒毛膜癌，子宫无病变。在其既往妊娠及人工流产19年后，绝经13年后，患者因间歇性腹痛入院。剖腹探查发现大网膜、乙状结肠系膜、腹膜种植有巨大肿瘤肿块，并转移至子宫浆膜层和胃壁。进行了肿瘤细胞减灭术。组织病理学报告显示为子宫外、非性腺纯绒毛膜癌。免疫过氧化物酶染色hCG呈强阳性，术前血清β-hCG水平升高证实了诊断。给予了多药化疗方案。然而，六个月后β-hCG水平迅速升高。诊断为肝、肺和纵隔转移。患者病情迅速恶化，一个月后死亡。尸检显示为晚期非性腺纯绒毛膜癌，无任何明显的原发灶。简要讨论了非性腺非妊娠性绒毛膜癌可能起源的相关问题。
