Kumar Naina, Arora Abhishek, Rathod Gunvanti, Mangla Mishu, Setty Aparna, Rathod Pooja T, Swetha Banka Sai
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bibinagar 508126, Hyderabad, Telangana, India.
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bibinagar 508126, Hyderabad, Telangana, India.
Oncoscience. 2025 Jul 28;12:70-78. doi: 10.18632/oncoscience.622. eCollection 2025.
Non-gestational ovarian choriocarcinomas (NGOC) are rare, distinct, highly aggressive tumors, primarily affecting young women. It accounts for less than 0.6% of malignant ovarian germ cell tumors. It is associated with a poorer prognosis compared to gestational choriocarcinoma.
A 36-year-old woman (P2L2) presented with intermittent heavy menstrual bleeding for the past three months. The urinary pregnancy test was positive. On abdominal examination, a solid mass consistent with 20-weeks gravid uterus was palpated in right iliac fossa. Bimanual pelvic examination revealed uterus deviated to the left and large (~12 × 10 cm) predominantly solid mass arising from right adnexa, adherent to the uterus. A mobile cystic mass (6 × 5 cm) was palpated in the left fornix. Ultrasonography showed normal-sized uterus with no gestational sac and a well-defined, solid-cystic right adnexal mass (10.2 × 7.8 × 7.8 cm) with vascularized solid areas and hemorrhage, initially suggesting an ectopic pregnancy. Serum β-hCG was markedly elevated (262,809 mIU/mL; normal level <5.0 mIU/mL). Magnetic Resonance Imaging (MRI) and Contrast-enhanced Computed Tomography (CECT) revealed right ovarian germ cell tumor, likely choriocarcinoma, without evidence of metastatic disease. On staging laparotomy, hemorrhagic right tubo-ovarian mass (8.5 × 8 × 7 cm) and left ovarian serous cystadenoma (8 × 7 × 3.5 cm) were identified. Histopathology and genomic studies confirmed stage IA1 NGOC. Patient completed two cycles of adjuvant chemotherapy with Bleomycin, Etoposide, Cisplatin, achieving complete response (β-hCG <5 mIU/mL), and is following up with serial β-hCG monitoring and CT scans for two years.
NGOC closely mimics ectopic pregnancy and gestational trophoblastic disease and requires early diagnosis with prompt surgical and chemotherapeutic intervention to optimize outcomes.
非妊娠性卵巢绒毛膜癌（NGOC）是一种罕见、独特且侵袭性很强的肿瘤，主要影响年轻女性。它占恶性卵巢生殖细胞肿瘤的比例不到0.6%。与妊娠性绒毛膜癌相比，其预后较差。
一名36岁女性（孕2产2），在过去三个月出现间歇性月经过多。尿妊娠试验呈阳性。腹部检查时，在右髂窝可触及一个与20周妊娠子宫大小相符的实性肿块。双合诊盆腔检查发现子宫向左偏移，右侧附件区有一个大的（约12×10厘米）、以实性为主的肿块，与子宫粘连。在左侧穹窿可触及一个活动的囊性肿块（6×5厘米）。超声检查显示子宫大小正常，未见妊娠囊，右侧附件区有一个边界清晰的实性囊性肿块（10.2×7.8×7.8厘米），有血管化的实性区域和出血，最初提示为异位妊娠。血清β-hCG显著升高（262,809 mIU/mL；正常水平<5.0 mIU/mL）。磁共振成像（MRI）和增强计算机断层扫描（CECT）显示右侧卵巢生殖细胞肿瘤，可能为绒毛膜癌，无转移病灶证据。在分期剖腹手术中，发现右侧出血性输卵管卵巢肿块（8.5×8×7厘米）和左侧卵巢浆液性囊腺瘤（8×7×3.5厘米）。组织病理学和基因组研究证实为IA1期NGOC。患者完成了两个周期的博来霉素、依托泊苷、顺铂辅助化疗，达到完全缓解（β-hCG<5 mIU/mL），并在接下来的两年中进行连续β-hCG监测和CT扫描随访。
NGOC与异位妊娠和妊娠滋养细胞疾病极为相似，需要早期诊断并及时进行手术和化疗干预，以优化治疗结果。
