Objective: Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat to
both the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presenting
as severe fetal anemia and postpartum hemorrhage.
Case Report: A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeks
after cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm 10.6-cm
heterogenous lesion in the endometrial cavity. Dilatation and curettage was done and a pathologic report
revealed choriocarcinoma. Metastatic workup showed lung metastasis. The patient achieved remission
after eight cycles of chemotherapy in the form of etoposide, methotrexate, actinomycin D, cyclophosphamide,
and vincristine. There was no evidence of recurrence in the subsequent 3 years of regular
follow up.
Conclusion: Although fetomaternal hemorrhage is a rare form of presentation of choriocarcinoma, its
presence should alert the physician to investigate the cause further. This chemotherapy regimen was
effective in our case and the patient needed to be followed up carefully.
Copyright © 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. This
is an open access article under the CC BY-NC-ND license
Objective: Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat toboth the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presentingas severe fetal anemia and postpartum hemorrhage.Case Report: A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeksafter cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm 10.6-cmheterogenous lesion in the endometrial cavity. Dilatation and curettage was done and a pathologic reportrevealed choriocarcinoma. Metastatic workup showed lung metastasis. The patient achieved remissionafter eight cycles of chemotherapy in the form of etoposide, methotrexate, actinomycin D, cyclophosphamide,and vincristine. There was no evidence of recurrence in the subsequent 3 years of regularfollow up.Conclusion: Although fetomaternal hemorrhage is a rare form of presentation of choriocarcinoma, itspresence should alert the physician to investigate the cause further. This chemotherapy regimen waseffective in our case and the patient needed to be followed up carefully.Copyright © 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. Thisis an open access article under the CC BY-NC-ND license
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