Shi Jiayu, Chen Ping
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
Front Oncol. 2025 Aug 27;15:1608856. doi: 10.3389/fonc.2025.1608856. eCollection 2025.
Choriocarcinoma belongs to a group of highly aggressive malignant gestational trophoblastic neoplasms. Choriocarcinoma is classified into two types based on the origin: a gestational type that arises following a normal or abnormal pregnancy and a non-gestational type resulting from trophoblastic differentiation of germ cells or somatic carcinomas. Primary cervical choriocarcinoma is rare; in women without a recent pregnancy, it is frequently misdiagnosed as other cervical carcinomas, which typically require surgery. Herein, we present a case of primary cervical choriocarcinoma in a 47-year-old woman who presented with irregular vaginal bleeding for five months, with her last pregnancy six years ago. She was initially misdiagnosed with cervical squamous cell carcinoma. Further evaluations, including serum human chorionic gonadotropin (hCG) and comprehensive pathological evaluation, confirmed the diagnosis of gestational choriocarcinoma. Immunohistochemistry showed positive hCG staining, negative p40 and p63 staining, and a high Ki-67 index (60%). Choriocarcinomas of the cervix are uncommon and share similar morphological characteristics with squamous cell carcinoma. Following systemic chemotherapy, hCG levels markedly declined, and the lesion resolved with good response. This case highlights the diagnostic pitfalls associated with primary cervical gestational choriocarcinoma and the importance of clinical correlation, particularly in patients without a recent pregnancy.
绒毛膜癌属于一组高度侵袭性的恶性妊娠滋养细胞肿瘤。绒毛膜癌根据起源可分为两种类型：一种是在正常或异常妊娠后发生的妊娠型，另一种是非妊娠型，由生殖细胞或体细胞癌的滋养细胞分化产生。原发性宫颈绒毛膜癌罕见；在近期无妊娠史的女性中，它常被误诊为其他宫颈癌，而其他宫颈癌通常需要手术治疗。在此，我们报告一例47岁女性原发性宫颈绒毛膜癌病例，该患者出现不规则阴道出血5个月，其最后一次妊娠是在6年前。她最初被误诊为宫颈鳞状细胞癌。进一步评估，包括血清人绒毛膜促性腺激素（hCG）检测和全面的病理评估，确诊为妊娠性绒毛膜癌。免疫组化显示hCG染色阳性，p40和p63染色阴性，Ki-67指数高（60%）。宫颈绒毛膜癌不常见，且与鳞状细胞癌具有相似的形态学特征。全身化疗后，hCG水平显著下降，病变消退，反应良好。该病例突出了原发性宫颈妊娠性绒毛膜癌相关的诊断陷阱以及临床关联的重要性，尤其是在近期无妊娠史的患者中。
