Fu Xiaofeng, Chen Wei, Zhu Jiang
Department of Ultrasound, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China.
Curr Med Imaging. 2025;21:e15734056386021. doi: 10.2174/0115734056386021250520043409.
Non-gestational Ovarian Choriocarcinoma (NGOC) is an extremely rare and highly malignant ovarian germ cell tumor with nonspecific clinical manifestations, making early diagnosis challenging. At present, detailed reports on the clinical and imaging characteristics of NGOC are scarce. This case report discusses a rare instance of NGOC in a prepubertal adolescent, complemented by a literature review to enhance clinicians' understanding of its presentation, diagnosis, and treatment.
A 10-year-old female with no history of menstruation or sexual activity presented with persistent lower abdominal pain and vaginal bleeding. Preoperative imaging revealed a large pelvic mass with heterogeneous echogenicity and vascularity. Serum Human Chorionic Gonadotropin (hCG) levels were markedly elevated (>297,000 IU/L). Preoperative Imaging: Ultrasonography and CT demonstrated a large, heterogeneous, hypervascular adnexal mass with features of necrosis and cystic changes, suggesting malignancy. Surgical and Pathological Findings: The mass, originating from the right adnexa, was removed via laparotomy. Histopathology confirmed NGOC, supported by immunohistochemistry, showing strong positivity for markers like CD146, CK18, HCG, and HPL, along with a high Ki-67 index (>90%).
In young females with no sexual life, significantly elevated HCG levels and imaging findings of a large heterogeneous adnexal mass should raise suspicion for NGOC. Early recognition and multimodal diagnostic approaches, including imaging, biochemical, and pathological assessments, are essential for timely intervention, reducing metastatic risk and improving prognosis. This report contributes to the understanding of NGOC and emphasizes the importance of accurate diagnosis for better patient outcomes.
非妊娠性卵巢绒毛膜癌（NGOC）是一种极其罕见且高度恶性的卵巢生殖细胞肿瘤，临床表现不具特异性，早期诊断具有挑战性。目前，关于NGOC临床和影像学特征的详细报道较为匮乏。本病例报告讨论了一名青春期前青少年中罕见的NGOC病例，并辅以文献综述，以增强临床医生对其表现、诊断和治疗的理解。
一名10岁女性，无月经或性活动史，出现持续性下腹痛和阴道出血。术前影像学检查显示盆腔有一个大肿块，回声不均匀且有血管。血清人绒毛膜促性腺激素（hCG）水平显著升高（>297,000 IU/L）。术前影像学检查：超声和CT显示一个大的、不均匀的、高血管性附件肿块，具有坏死和囊性变特征，提示为恶性。手术及病理结果：肿块起源于右侧附件，通过剖腹手术切除。组织病理学确诊为NGOC，免疫组化支持这一诊断，显示CD146、CK18、hCG和HPL等标志物呈强阳性，Ki-67指数高（>90%）。
在无性生活的年轻女性中，hCG水平显著升高且影像学显示附件有大的不均匀肿块应怀疑为NGOC。早期识别和包括影像学、生化及病理评估在内的多模式诊断方法对于及时干预、降低转移风险和改善预后至关重要。本报告有助于对NGOC的理解，并强调准确诊断对改善患者预后的重要性。
