Dombrovsky Inessa, Tilden Hannah R, Aftandilians Tania, Wong Shirley, Stowe Robert J
Department of Women's Health, Arrowhead Regional Medical Center, Colton, CA, USA.
Am J Case Rep. 2020 Jan 27;21:e917656. doi: 10.12659/AJCR.917656.
BACKGROUND Choriocarcinoma is the most aggressive form of gestational trophoblastic disease and usually occurs in women of childbearing age, most commonly within 1 year after an abnormal pregnancy. Postmenopausal choriocarcinoma is exceptionally rare and few cases have been described in the literature. CASE REPORT We present the case of a 66-year-old woman who presented to the Emergency Department with sudden onset of left upper- and lower-extremity weakness. She was found to have a brain mass, which was excised by neurosurgery and found to be a choriocarcinoma. She was then started on standard first-line therapy of EMACO, but was subsequently lost to follow-up. CONCLUSIONS Postmenopausal choriocarcinoma is rare and there are few case reports in the literature. It is a rare but possibly under-diagnosed metastatic disease in women. At present, a postmenopausal woman without a clear primary tumor should have a pregnancy test performed to rule out choriocarcinoma, as it is readily responsive to therapy.
背景 绒毛膜癌是妊娠滋养细胞疾病中最具侵袭性的形式,通常发生在育龄妇女中,最常见于异常妊娠后1年内。绝经后绒毛膜癌极为罕见,文献中仅有少数病例报道。病例报告 我们报告一例66岁女性,因突发左上肢和下肢无力就诊于急诊科。她被发现有一个脑部肿块,经神经外科手术切除后发现是绒毛膜癌。随后她开始接受标准的一线EMACO治疗,但随后失访。结论 绝经后绒毛膜癌罕见,文献中病例报告较少。它是一种在女性中罕见但可能诊断不足的转移性疾病。目前,对于无明确原发肿瘤的绝经后女性,应进行妊娠试验以排除绒毛膜癌,因为它对治疗反应良好。