ABSTRACT
We report a case of a young female patient presenting with a high serum beta-HCG levels, amenorrhea, nausea and anemia which mimicked pregnancy followed by upper gastrointestinal bleeding. A gastric tumor was shown on endoscopy. Histopathologic evaluation revealed Primary Gastric Choriocarcinoma (PGC). The patient was treated with three cycles of standard nongestational choriocarcinoma chemotherapy. Tumor persistence was evidenced by CT Scans and high serum beta-HCG levels. The patient died approximately six months after diagnosis. Our case report suggest that PGC is a highly aggressive tumor that is often associated with liver and lungs metastasis without evidence of pelvic organ abnormality and is associated with some hormonal effects, such as amenorrhea, anemia, nausea and vomiting mimicking pregnancy in young adult female
Subject(s)
Choriocarcinoma, Non-gestational/diagnosis , Diagnostic Errors , Stomach Neoplasms/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor/blood , Bleomycin/administration & dosage , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/secondary , Chorionic Gonadotropin, beta Subunit, Human/blood , Cisplatin/administration & dosage , Etoposide/administration & dosage , Fatal Outcome , Female , Humans , Ifosfamide/administration & dosage , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Methotrexate/administration & dosage , Paclitaxel/administration & dosage , Pregnancy , Pregnancy, Ectopic/diagnosis , Salvage Therapy , Stomach Neoplasms/drug therapy , Young AdultABSTRACT
Paroxysmal nocturnal hemoglobinuria is a rare hematological disorder. It is an uncommon cause of intravascular hemolysis, thrombosis and bone marrow suppression. We report a 19-year-old female patient admitted to the hospital with pancytopenia. Workout of pancytopenia disclosed paroxysmal nocturnal hemoglobinuria. The patient responded well to treatment with blood transfusions, steroids and eculizumab. We discuss the underlying pathophysiology, clinical manifestations and treatment of this rare entity.
