Incidental Placental Choriocarcinoma in a Term Pregnancy: A Case Report

Christopher Chung; Ming-Shian Kao; Deborah Gersell

Disclosures

J Med Case Reports 

In This Article

Case Presentation

The patient is an 18 year-old African American Gravida 1 Para 0 at her 39th weeks of gestation who presented to a hospital in the St. Louis area in early labor. After rupture of membranes, light meconium was noted. The patient subsequently delivered a viable female infant vaginally, weighing 3641 g, with Apgar scores of 9 and 9 at 1 and 5 minutes. Her pregnancy course was complicated by gestational hypertension during the third trimester. She was treated with magnesium sulfate during labor for possible pre-eclampsia due to elevated blood pressure intrapartum. Her blood pressure was normal after delivery, and her post partum course was unremarkable. The placenta appeared to be grossly normal with a 3 vessel cord at the time of delivery. Because of the patient's history of gestational hypertension, the placenta was sent to pathology and placental choriocarcinoma was diagnosed (Figure 1 & Figure 2). She was then referred to and followed closely by the Gynecologic Oncology service. Her serum beta human chorionic gonadotropin (hCG) dropped from 3070 mIU/ml to less than 2 mIU/ml six weeks post partum. No chemotherapy was initiated. She had also undergone multiple studies such as chest x-ray and computed tomography (CT) scan which all ruled out metastasis during the one year post partum period. The infant was followed by the pediatric service. To date, both mother and baby have been disease free for eight years.

Figure 1.

Interface between choriocarcinoma with central necrosis (top) and normal placenta (hematoxilin and eosin staining).

Figure 2.

Villi surrounded by collars of neoplastic trophoblast (arrows).

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