A RARE CASE OF CHORIOCARCINOMA OF OVARY, DIAGNOSTIC DILEMMA: A CASE REPORT

Dr. Garima Kanotra*, Dr. Mamta Mahajan, Dr. Pragya Tiwari and Dr. Shreya Mishra

ABSTRACT

Ovarian choriocarcinomas are extremely rare and account for < 0.6% of all ovarian neoplasms.[1] Preoperative diagnosis of extrauterine choriocarcinoma is difficult due to non-specific clinical presentation and its resemblance to ectopic pregnancy. Here we present a case of 21 year old unmarried female who presented to the gynae OPD of Dr RPGMC Tanda with severe pain abdomen, abdominal lump and vaginal bleeding and since 1 week. Six weeks back she was operated for a suspected ectopic pregnancy i.e left salpingectomy, but escaped histo-pathological diagnosis. On USG and CT there was an echogenic solid mass (20*22cms) extending from Pouch of douglas upto left adnexa with multiple sepatations. She underwent exploratory laparotomy proceed left oophorectomy. The diagnosis of ovarian choriocarinoma was made on the basis of histopathological examination and IHC report. Furthermore without molecular genetic analysis it was not possible to differentiate between gestational and non gestational choriocarcinoma. It was classified as FIGO stage 1 and WHO low risk .She underwent nine cycles of single agent chemotherapy (inj methotrexate) and had complete remission. The rarity of this tumor makes differentiating ectopic pregnancy and choriocarcinoma difficult, hence a high degree of suspicion is needed.

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