ABSTRACT
This is a case report of a 56-year-old woman with a history of postmenopausal bleeding, who presented with an endometrioid adenocarcinoma and a co-existing non-gestational choriocarcinoma. We performed robotic assisted hysterectomy, bilateral oophorectomy and pelvic lymphadectomy, and histopathologic examination revealed a malignant tumour showing an endometrioid adenocarcinoma grade 2 with a minor component of choriocarcinoma incorporated into the adenocarcinoma. We compared data from exome sequencing of DNA from tumour and blood to show, that the choriocarcinoma component was most likely non-gestational.
Subject(s)
Carcinoma, Endometrioid , Choriocarcinoma, Non-gestational , Choriocarcinoma , Carcinoma, Endometrioid/diagnosis , Carcinoma, Endometrioid/surgery , Choriocarcinoma/diagnosis , Choriocarcinoma/surgery , Choriocarcinoma, Non-gestational/diagnosis , Choriocarcinoma, Non-gestational/surgery , Female , Humans , Hysterectomy , Middle Aged , Pregnancy , UterusABSTRACT
Uterine choriocarcinoma is a trophoblastic neoplasm that is most commonly gestational but can also be non-gestational in origin. However, primary non-gestational uterine choriocarcinoma is very rare, with only few cases having been reported. We report a case of a premenopausal woman who had initially been diagnosed with myoma delivery but who was discovered to have primary non-gestational uterine choriocarcinoma. This 46-year-old woman had no history of pregnancy. She was referred to our hospital for treatment of the myoma delivery. After tumor removal, histological examination led to the diagnosis of choriocarcinoma. The serum human chorionic gonadotropin level (207,300 mIU/mL) prior to surgery was abnormally high, and because the computed tomography scans additionally revealed lung metastasis, the patient was diagnosed with FIGO stage III choriocarcinoma. Due to the lack of pregnancy history and abstinence from sexual intercourse for >1 year, we performed short tandem repeat analysis, and diagnosed the patient with non-gestational choriocarcinoma. Despite treatments using multiple anticancer agents after the surgery, the patient died 1 year after starting the treatments. On this occasion, we report a very rare case of a premenopausal woman who was diagnosed with primary non-gestational uterine choriocarcinoma mimicking leiomayoma.
Subject(s)
Choriocarcinoma, Non-gestational/pathology , Choriocarcinoma, Non-gestational/surgery , Diagnosis, Differential , Leiomyoma/pathology , Uterine Neoplasms/pathology , Choriocarcinoma, Non-gestational/diagnosis , Female , Humans , Leiomyoma/diagnosis , Middle Aged , Treatment Outcome , Uterine Neoplasms/diagnosis , Uterus/pathologyABSTRACT
BACKGROUND: Nongestational choriocarcinoma (NGC) is a rare germ cell tumor, accounting for <0.6% of all gestational tumors, and has a poor prognosis when metastasized. NGC with metastasis to the brain is reported even less frequently. Gestational choriocarcinoma (GC) when metastasized to the brain has a higher morbidity and mortality but has been known to be a chemosensitive and radiosensitive lesion, and NGC is chemoresistant with an even worse prognosis. Currently, there is no consensus for treatment for metastatic NGC to the brain. CASE DESCRIPTION: This 66-year-old postmenopausal female presented with left upper extremity weakness more pronounced in her hand and a workup demonstrating a hemorrhagic lesion over the right frontal parietal lobe. Her metastatic workup was negative, leading to a craniotomy for resection of the mass. The pathology was consistent with metastatic GC of nongestational origin. CONCLUSIONS: Because of its chemosensitive nature, reports of optimal metastatic GC treatment include radiation alone, chemotherapy without radiation, surgical resection, or combined multimodal therapy. No recommendations for NGC metastasized to the brain have been reported. We propose a systematic workup for hemorrhagic brain lesions to include the proposed imaging modalities and serum markers, including ß-human chorionic gonadotropin, to aid early diagnosis. Based on a review of the literature, we recommend surgical resection with adjuvant therapy for accessible symptomatic metastatic GC and NGC to the brain for optimal patient outcomes. Chemotherapy and radiation alone without surgical resection can be considered for asymptomatic GC metastasis to the brain.
Subject(s)
Brain Neoplasms/diagnostic imaging , Brain Neoplasms/surgery , Choriocarcinoma, Non-gestational/diagnostic imaging , Choriocarcinoma, Non-gestational/surgery , Aged , Brain Neoplasms/secondary , Female , Humans , Treatment OutcomeABSTRACT
RATIONALE: Rare uterine choriocarcinoma can be differentiated gestational from nongestational choriocarcinoma by using short tandem repeats (STRs). PATIENT CONCERNS: A 56-year-old Taiwanese woman underwent staging surgery because of suspicion of high-grade endometrial cancer. The pathology-confirmed uterine tumor with syncytiotrophoblasts and decidual change of the endometrium was harvested. DIAGNOSIS: Uterine nongestational choriocarcinoma. INTERVENTIONS: The tumor specimen, the patient's blood, and her husband's blood were drawn for STRs analysis using polymerase chain reaction amplification kit. The genotype of the tumor cells was solely maternal and made the diagnosis of uterine nongestational choriocarcinoma. OUTCOME: Adjuvant chemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine regimen achieved good response in the patient. The patient is now recurrence-free for 12âmonths. LESSONS: STRs aid precise classification of rare choriocarcinoma. We encourage using the method to analyze suspicious choriocarcinoma.
Subject(s)
Choriocarcinoma, Non-gestational/genetics , Choriocarcinoma, Non-gestational/pathology , Microsatellite Repeats , Neoplasm Staging/methods , Uterine Neoplasms/genetics , Uterine Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/surgery , Female , Humans , Middle Aged , Postmenopause , Uterine Neoplasms/drug therapy , Uterine Neoplasms/surgeryABSTRACT
STUDY OBJECTIVE: To show a surgical video in which an incidentally found Meckel diverticulum was resected with a natural orifice-assisted laparoscopic approach during para-aortic resection of a retroperitoneal schwannoma. DESIGN: Case report (Canadian Task Force classification III). SETTING: Tertiary referral center in New Haven, Connecticut. INTERVENTIONS: This is a step-by-step illustration for resection of a retroperitoneal para-aortic schwannoma and of an incidentally found Meckel diverticulum. The patient was a 39-year-old white woman diagnosed with stage IV choriocarcinoma with metastasis to the lungs and left para-aortic area. She received chemotherapy in the form of etoposide, methotrexate, actinomycin-D, cyclophosphamide, oncovine (EMA-CO) and had an excellent clinical response with resolution of all metastatic disease except for the para-aortic mass. Therefore, she was taken to the operating room for laparoscopic resection of the persistent left para-aortic mass. After placement of four 5-mm abdominal ports, the pelvis and abdomen were explored and revealed an incidental Meckel diverticulum as well as the 5 cm left para-aortic mass. The peritoneum overlying the para-aortic mass was incised and the retroperitoneum explored. Given the proximity to the mass, left ureterolysis was performed. The retroperitoneal attachments were resected, and the left para-aortic mass was removed without any complications. At this point attention was turned to the Meckel diverticulum. In order not to extend the abdominal incisions, a posterior colpotomy was performed in the cul-de-sac equidistant from the uterosacral ligaments. Endo-GIA (Covidien, New Haven CT) was introduced through the 10-mm port site at the posterior colpotomy. Meckel diverticulum was resected without narrowing the lumen of the distal ileum. The specimen was removed in a contained manner through posterior colpotomy. MEASUREMENTS AND MAIN RESULTS: The procedure was performed without any complications. The patient had an uneventful postoperative course and was discharged home on postoperative day 0. Pathology revealed a retroperitoneal schwannoma with negative margins and benign Meckel diverticulum without ectopic gastric or pancreatic tissue. The patient has been disease-free since the completion of surgery. CONCLUSION: Laparoscopic resection of the retroperitoneal schwannoma and Meckel diverticulum were successfully performed in this patient with history of stage IV choriocarcinoma. To our knowledge, this is the first report describing a natural orifice-assisted laparoscopic approach for resection of Meckel diverticulum. Natural orifice-assisted laparoscopy should be considered when the surgeon needs to remove a large specimen and/or to introduce >5-mm diameter instruments into the peritoneal cavity without having to extend the abdominal incisions.
Subject(s)
Choriocarcinoma, Non-gestational/surgery , Digestive System Surgical Procedures/methods , Laparoscopy/methods , Meckel Diverticulum/surgery , Natural Orifice Endoscopic Surgery/methods , Neurilemmoma/surgery , Retroperitoneal Neoplasms/surgery , Adult , Choriocarcinoma, Non-gestational/complications , Female , Humans , Incidental Findings , Meckel Diverticulum/complications , Neurilemmoma/complications , Neurilemmoma/secondary , Para-Aortic Bodies/pathology , Retroperitoneal Neoplasms/complications , Retroperitoneal Neoplasms/secondaryABSTRACT
Primary choriocarcinoma of the urinary bladder is a rare entity, and should be distinguished from urothelial carcinoma with trophoblastic differentiation. The leading treatment modalities include surgical extirpation, chemotherapy, and radiation; however, survival remains poor. Herein we describe a rare case of choriocarcinoma of the bladder in a man who presented for evaluation with hematuria and subsequently underwent radical cystectomy with urinary diversion. Diagnosis of extragonadal germ cell tumor was confirmed using fluorescence in situ hybridization identification of isochromosome 12p.
Subject(s)
Choriocarcinoma, Non-gestational/diagnosis , Chromosomes, Human, Pair 12/genetics , Neoplasms, Germ Cell and Embryonal/diagnosis , Urinary Bladder Neoplasms/diagnosis , Aged , Choriocarcinoma, Non-gestational/genetics , Choriocarcinoma, Non-gestational/surgery , Cystectomy , Humans , Isochromosomes/genetics , Male , Neoplasms, Germ Cell and Embryonal/genetics , Neoplasms, Germ Cell and Embryonal/surgery , Urinary Bladder Neoplasms/genetics , Urinary Bladder Neoplasms/surgery , Urinary DiversionABSTRACT
We present the case of a 21-year-old male patient who was diagnosed with metastatic brain choriocarcinoma after presenting with a spontaneous cerebral hemorrhage. The treatment performed for this patient was an open surgery with full excision of the lesion. It is known that this kind of tumor is usually found in women, with low incidence in men. With this information as a baseline, we found multiple pulmonary metastases and a primary pure choriocarcinoma in his testicle.
Apresentamos o caso de um paciente do sexo masculino, de 21 anos de idade, o qual foi diagnosticado com um coriocarcinoma cerebral metastático após apresentar uma hemorragia cerebral espontânea. O tratamento realizado para este paciente foi uma cirurgia aberta com excisão total da lesão. Sabe-se que este tipo de tumor é normalmente encontrado em mulheres, com baixa incidência no sexo masculino. A partir desta informação, encontramos múltiplas metástases pulmonares e um coriocarcinoma primário puro em seu testículo.
Subject(s)
Humans , Male , Adult , Brain Neoplasms , Choriocarcinoma, Non-gestational , Neoplasm Metastasis , Testicular Neoplasms , Choriocarcinoma, Non-gestational/surgerySubject(s)
Brain Neoplasms/secondary , Choriocarcinoma, Non-gestational/pathology , Lung Neoplasms/secondary , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/pathology , Brain Neoplasms/surgery , Choriocarcinoma, Non-gestational/surgery , Female , Humans , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Magnetic Resonance ImagingABSTRACT
This case report demonstrates the feasibility of laparoscopic and fertility-preserving approach in nongestational choriocarcinoma of the ovary (NGCO). Pure NGCO is a rare malignant condition. In the last decade, only 14 cases have been reported in the literature. The use of laparoscopy and fertility-preserving procedures in nonepithelial ovarian malignancies is extremely controversial. A 23-year-old woman underwent emergency laparoscopy due to acute abdominal pain associated with an 8-cm large adnexal mass. The initial procedure consisted only of a left oophoroplasty, and histology revealed a tumor of high malignant potential compatible with a primary NGCO. Approximately 3 weeks after initial surgery, she was submitted to a laparoscopic staging surgery, including left adnexectomy, omentectomy, peritoneal biopsies, and retroperitoneal lymphadenectomy. Final pathology confirmed an International Federation of Gynecology and Obstetrics stage IIB NGCO. Before initiation of adjuvant chemotherapy based on 3 courses of bleomycin, etoposide, and cisplatin, the patient received goserelin for ovarian suppression. Nine months after therapy, the patient presented no signs of recurrence and reassumed normal menstruation cycles with normal levels of gonadotropins and tumor markers. The current report brings new insights into the possibility of using use minimally invasive surgery and a combination of fertility-preserving methods for the treatment of NGCO.
Subject(s)
Choriocarcinoma, Non-gestational/surgery , Cisplatin/administration & dosage , Fertility Preservation/methods , Laparoscopy , Neoplasm Recurrence, Local/prevention & control , Neoplasms, Germ Cell and Embryonal/surgery , Ovarian Neoplasms/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor , Chemotherapy, Adjuvant , Choriocarcinoma, Non-gestational/diagnosis , Choriocarcinoma, Non-gestational/pathology , Female , Humans , Neoplasms, Germ Cell and Embryonal/diagnosis , Neoplasms, Germ Cell and Embryonal/pathology , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/pathology , Pregnancy , Treatment OutcomeABSTRACT
We present a rare case of 23-year-old patient with metastatic choriocarcinoma that presented life threatening abdominal bleeding from liver metastases shortly after initiation of treatment with chemotherapy and was treated by emergency embolization of the hepatic vessels. Although the bleeding was controlled, the patient succumbed to the disease on the 15th day after admission. Conclusions: Incontrollable hemorrhagic complications are the most common cause of death in choriocarcinoma metastatic patients. Angioembolization is an effective way of ceasing the bleeding and a potentially life saving measure.
Subject(s)
Choriocarcinoma, Non-gestational/secondary , Choriocarcinoma, Non-gestational/surgery , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Uterine Artery Embolization/methods , Uterine Hemorrhage/surgery , Female , Hemodynamics , Humans , Uterine Hemorrhage/etiology , Young AdultABSTRACT
Choriocarcinoma is categorized as either gestational or nongestational depending on its origin. Nongestational choriocarcinoma originated in the trophoblastic differentiation is a rare but an aggressive tumor. This article reports a nongestational case of a uterine endometrial carcinoma with trophoblastic differentiation. A 54-year-old woman with a history of atypical genital bleeding that underwent semi-radical hysterectomy, bilateral salpingo-oophrectomy, and pelvic lymph nodes dissection. Pathological investigation showed that the tumor had endometrioid adenocarcinoma and choriocarcinomatous components. Although a series of multimodality treatments including craniotomy were performed, she died of aggressive lung and brain metastases one year after the primary surgery.
Subject(s)
Carcinoma, Endometrioid/pathology , Choriocarcinoma, Non-gestational/pathology , Endometrial Neoplasms/pathology , Mixed Tumor, Malignant/pathology , Carcinoma, Endometrioid/diagnostic imaging , Carcinoma, Endometrioid/surgery , Choriocarcinoma, Non-gestational/diagnostic imaging , Choriocarcinoma, Non-gestational/surgery , Endometrial Neoplasms/diagnostic imaging , Endometrial Neoplasms/surgery , Female , Humans , Hysterectomy , Middle Aged , Mixed Tumor, Malignant/diagnostic imaging , Mixed Tumor, Malignant/surgery , Ovariectomy , Salpingectomy , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To study nongestational ovarian choriocarcinoma (NGOC) with lung metastases: its early diagnosis, optimal therapeutic method, and prognosis. STUDY DESIGN: Twelve cases of NGOC with lung metastases treated in Peking Union Medical College Hospital from 1982-2011 were analyzed retrospectively. The 12 cases included 9 pure NGOCs and 3 mixed with other germ cell tumors (mature teratoma, endodermal sinus tumor and embryonal carcinoma components, and dysgerminoma, respectively). Chemotherapy was given in all 12 cases, mainly including EMA/CO, BEP, and RESULTS: The median age for the cases was 23.9 years. Abdominal pain was the most common symptom (7/12). Follow-up was available for 11 cases, ranging from 17-174 months (median, 86.6 months). Of those, only 1 patient died of the disease, at 42 months from the disease onset. The other patient for whom follow-up was not available gave up treatment due to chemoresistance and disease progression. An overall sustained remission had been achieved in 10 cases (83.3%). CONCLUSION: Surgery combined with the appropriate chemotherapy regimen can improve therapeutic efficacy and survival in the treatment of NGOC with lung metastasis, even in recurrent or chemorefractory cases. Commencement of EMA/CO chemotherapy, which seems to be associated with better prognosis, should be considered as a good choice of treatment. Conservative surgery is acceptable for young patients desiring to preserve fertility.
Subject(s)
Choriocarcinoma, Non-gestational/pathology , Lung Neoplasms/secondary , Ovarian Neoplasms/pathology , Abdominal Pain , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Child , China , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/surgery , Cyclophosphamide/therapeutic use , Dactinomycin/therapeutic use , Etoposide/therapeutic use , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Methotrexate/therapeutic use , Middle Aged , Neoplasm Staging , Prognosis , Remission Induction , Retrospective Studies , Treatment Outcome , Vincristine/therapeutic use , Young AdultSubject(s)
Choriocarcinoma, Non-gestational/diagnosis , Menorrhagia/etiology , Shock, Hemorrhagic/etiology , Uterine Cervical Neoplasms/diagnosis , Adult , Choriocarcinoma, Non-gestational/surgery , Fatal Outcome , Female , Humans , Hysterectomy , Neoplasm Metastasis , Uterine Cervical Neoplasms/surgeryABSTRACT
Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational choriocarcinoma of the ovary is extremely rare, and its diagnosis is very difficult during the reproductive years. We present a case of a 33-year-old woman diagnosed with pure nongestational ovarian choriocarcinoma. Following surgery, multiple courses of a chemotherapy regimen of etoposide, methotrexate, and actinomycin-D (EMA) were effective.
Subject(s)
Choriocarcinoma, Non-gestational/pathology , Ovarian Neoplasms/pathology , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/surgery , Combined Modality Therapy , Dactinomycin/administration & dosage , Etoposide/administration & dosage , Female , Humans , Methotrexate/administration & dosage , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgery , PrognosisABSTRACT
Choriocarcinoma is a highly malignant tumor of trophoblastic origin. Most cases occur in association with preceding gestational events. However, on very rare occasions, nongestational choriocarcinoma arises from germ cell or trophoblastic differentiation in different types of carcinoma. This article reports the case of a 58-year-old woman with primary nongestational choriocarcinoma of the uterus that developed 19 years after her final pregnancy and 4 years after menopause. A total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathological examination showed choriocarcinoma of the uterus without components of other germ cell tumors. Karyotype analysis of the tumor cells demonstrated XX. We confirmed its nongestational origin by DNA polymorphism analysis at 15 short tandem repeat loci. After surgery, the patient was given four courses of combination chemotherapy. She is still alive and there has been no evidence of recurrence 3 years after surgery.
Subject(s)
Choriocarcinoma, Non-gestational/genetics , Ovarian Neoplasms/genetics , Choriocarcinoma, Non-gestational/pathology , Choriocarcinoma, Non-gestational/surgery , DNA, Neoplasm/chemistry , DNA, Neoplasm/genetics , Female , Histocytochemistry , Humans , Karyotyping , Middle Aged , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Polymerase Chain Reaction , Polymorphism, Genetic , Postmenopause/geneticsSubject(s)
Choriocarcinoma, Non-gestational/diagnosis , Chorionic Gonadotropin/blood , Diagnostic Errors , Lung Neoplasms/diagnosis , Pregnancy/blood , Adult , Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Choriocarcinoma, Non-gestational/diagnostic imaging , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/surgery , Cyclophosphamide/therapeutic use , Dactinomycin/therapeutic use , Etoposide/therapeutic use , False Positive Reactions , Female , Humans , Leucovorin/therapeutic use , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Methotrexate/therapeutic use , Radiography , Treatment Outcome , Vincristine/therapeutic use , Vitamin B Complex/therapeutic useABSTRACT
Spontaneous rupture of a mediastinal germ cell tumor, while rare, is always accompanied by bleeding. In this report, we describe a case of a primary mediastinal mixed germ cell tumor that presented with bilateral massive hemothorax and hemorrhagic shock. An urgent thoracotomy, which was performed to control bleeding, confirmed bilateral hemothorax secondary to a ruptured mediastinal tumor. Pathologic diagnosis revealed the mediastinal tumor to be mixed choriocarcinoma and immature teratoma, with lung metastatic choriocarcinoma. The patient recovered well from the operation and received salvage chemotherapy. Two years after diagnosis, the patient remains in remission with no evidence of disease.
Subject(s)
Choriocarcinoma, Non-gestational/complications , Hemostasis, Surgical/methods , Hemothorax/etiology , Mediastinal Neoplasms/complications , Shock, Hemorrhagic/etiology , Teratoma/complications , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor/blood , Blood Transfusion , Chemotherapy, Adjuvant , Choriocarcinoma, Non-gestational/diagnostic imaging , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/metabolism , Choriocarcinoma, Non-gestational/secondary , Choriocarcinoma, Non-gestational/surgery , Chorionic Gonadotropin, beta Subunit, Human/blood , Combined Modality Therapy , Diagnostic Errors , Fluid Therapy , Humans , Klinefelter Syndrome/complications , Klinefelter Syndrome/diagnosis , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Lung Neoplasms/surgery , Male , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/diagnostic imaging , Mediastinal Neoplasms/drug therapy , Mediastinal Neoplasms/surgery , Neoplasm, Residual , Pneumonectomy/methods , Remission Induction , Rupture, Spontaneous , Shock, Hemorrhagic/surgery , Shock, Hemorrhagic/therapy , Teratoma/diagnosis , Teratoma/diagnostic imaging , Teratoma/drug therapy , Teratoma/secondary , Teratoma/surgery , Thyrotropin/metabolism , Tomography, X-Ray ComputedSubject(s)
Choriocarcinoma, Non-gestational/diagnosis , Ovarian Neoplasms/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bleomycin/therapeutic use , Choriocarcinoma, Non-gestational/drug therapy , Choriocarcinoma, Non-gestational/pathology , Choriocarcinoma, Non-gestational/surgery , Cisplatin/therapeutic use , Etoposide/therapeutic use , Fatal Outcome , Female , Hexachlorocyclohexane/blood , Humans , Laparoscopy , Middle Aged , Neoplasm Staging , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgeryABSTRACT
Nongestational choriocarcinoma of the ovary is a rare germ cell tumor with a worse prognosis than gestational choriocarcinoma. In this report we present a case of nongestational chroriocarcinoma where the EMA/CO regime was applied. The clinical features, management, and outcome are discussed.