Sano Rikiya, Moriya Takuya, Suzuki Soichiro, Saito Wataru, Shimoya Koichiro, Shiota Mitsuru
Department of Gynecologic Oncology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Pathol Int. 2019 Mar;69(3):160-164. doi: 10.1111/pin.12763. Epub 2019 Feb 18.
Uterine choriocarcinoma is a trophoblastic neoplasm that is most commonly gestational but can also be non-gestational in origin. However, primary non-gestational uterine choriocarcinoma is very rare, with only few cases having been reported. We report a case of a premenopausal woman who had initially been diagnosed with myoma delivery but who was discovered to have primary non-gestational uterine choriocarcinoma. This 46-year-old woman had no history of pregnancy. She was referred to our hospital for treatment of the myoma delivery. After tumor removal, histological examination led to the diagnosis of choriocarcinoma. The serum human chorionic gonadotropin level (207,300 mIU/mL) prior to surgery was abnormally high, and because the computed tomography scans additionally revealed lung metastasis, the patient was diagnosed with FIGO stage III choriocarcinoma. Due to the lack of pregnancy history and abstinence from sexual intercourse for >1 year, we performed short tandem repeat analysis, and diagnosed the patient with non-gestational choriocarcinoma. Despite treatments using multiple anticancer agents after the surgery, the patient died 1 year after starting the treatments. On this occasion, we report a very rare case of a premenopausal woman who was diagnosed with primary non-gestational uterine choriocarcinoma mimicking leiomayoma.
子宫绒毛膜癌是一种滋养层肿瘤,最常见于妊娠相关,但也可能起源于非妊娠情况。然而,原发性非妊娠性子宫绒毛膜癌非常罕见,仅有少数病例报道。我们报告一例绝经前女性病例,该患者最初被诊断为肌瘤分娩,但后来被发现患有原发性非妊娠性子宫绒毛膜癌。这位46岁的女性没有怀孕史。她因肌瘤分娩被转诊至我院治疗。肿瘤切除后,组织学检查确诊为绒毛膜癌。手术前血清人绒毛膜促性腺激素水平(207,300 mIU/mL)异常升高,且计算机断层扫描还显示有肺转移,该患者被诊断为国际妇产科联盟(FIGO)III期绒毛膜癌。由于缺乏妊娠史且已禁欲超过1年,我们进行了短串联重复序列分析,诊断该患者为非妊娠性绒毛膜癌。尽管术后使用了多种抗癌药物进行治疗,但患者在开始治疗1年后死亡。在此,我们报告一例非常罕见的绝经前女性病例,该患者被诊断为原发性非妊娠性子宫绒毛膜癌,最初表现类似平滑肌瘤。