Unusual clinical course, Mistake in diagnosis
Inessa Dombrovsky, Hannah R. Tilden, Tania Aftandilians, Shirley Wong, Robert J. Stowe
Department of Women’s Health, Arrowhead Regional Medical Center, Colton, CA, USA
Am J Case Rep 2020; 21:e917656
Available online: 2020-01-24
Choriocarcinoma is the most aggressive form of gestational trophoblastic disease and usually occurs in women of childbearing age, most commonly within 1 year after an abnormal pregnancy. Postmenopausal choriocarcinoma is exceptionally rare and few cases have been described in the literature.
CASE REPORT: We present the case of a 66-year-old woman who presented to the Emergency Department with sudden onset of left upper- and lower-extremity weakness. She was found to have a brain mass, which was excised by neurosurgery and found to be a choriocarcinoma. She was then started on standard first-line therapy of EMACO, but was subsequently lost to follow-up.
CONCLUSIONS: Postmenopausal choriocarcinoma is rare and there are few case reports in the literature. It is a rare but possibly under-diagnosed metastatic disease in women. At present, a postmenopausal woman without a clear primary tumor should have a pregnancy test performed to rule out choriocarcinoma, as it is readily responsive to therapy.
Keywords: Choriocarcinoma, Neoplasm Metastasis, Postmenopause