Case Report
 
Review of a case of choriocarcinoma with vaginal metastases
Hoo PS1, Nik Rafiza Afendi2, Mas Irfan Jaya Mahamooth3, Ahmad Amir Ismail2, Rahimah Abdul Rahim2, Ahmad Akram Omar2
1Clinical lecturer, Obstetrics & Gynecology department, School of Medical Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
2Senior lecturer, Obstetrics & Gynecology department, School of Medical Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
3Trainee lecturer, Obstetrics & Gynecology department, School of Medical Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.

Article ID: 100014G06HS2016
doi:10.5348/G06-2016-14-CR-8

Address correspondence to:
Pek Sung Hoo
Obstetrics & Gynecology department
Hospital Universiti Sains Malaysia, School of Medical Science
Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
Malaysia

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How to cite this article:
Hoo PS, Afendi NR, Mahamooth MIJ, Ismail AA, Rahim RA, Omar AA. Review of a case of choriocarcinoma with vaginal metastases. Edorium J Gynecol Obstet 2016;2:48–51.


Abstract
Introduction: Choriocarcinoma is a rare highly malignant tumor that arises from trophoblastic tissue. It metastasis rapidly to vital organs including lungs and brain. It shows very good response to appropriately chosen chemotherapeutic regimen.
Case Report: We illustrate a case of gestational choriocarcinoma with vaginal metastasis. This lady initially presented to us with heavy menstrual bleeding approximately nine months after giving birth to her first child. On vaginal examination revealed the presence of a anterior vaginal wall growth measuring about 2x3 cm which was biopsied. While waiting for the HPE results, patient developed another two episodes of hypovolemia due to profuse blood loss, warranting uterine artery embolization. Formal histopathology report (HPE) revealed the presence of gestational trophoblastic disease consistent with metastatic choriocarcinoma. Patient is currently undergoing chemotherapy with EMACO (etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine) regime and is responding well.
Conclusion: Metastatic choriocarcinoma may present solely as a vaginal growth. It may pose initial diagnostic dilemmas and thus treatment delay.

Keywords: Choriocarcinoma, Uterine artery embolization, Vaginal metastases


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Author Contributions
Hoo P.S. – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nik Rafiza Afendi – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published.
Mas Irfan Jaya Mahamooth – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Ahmad Amir Ismail – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published.
Rahimah Abdul Rahim – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Ahmad Akram Omar – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Hoo P.S. et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.