Prognosis of gestational choriocarcinoma diagnosed incidentally during laparoscopy for a presumed cornual pregnancy: a report of five cases

Abstract

The clinical presentations of gestational choriocarcinoma vary markedly, and a misdiagnosis could be made in atypical patients if simply relying on clinical features. Laparoscopic resection of uterine mass lesion is rarely used in gestational choriocarcinoma diagnosis because of the fear of heavy blood loss and distant metastasis. Five patients who were preoperatively diagnosed as having cornual pregnancy underwent laparoscopic resection of mass lesion and then proved to have gestational choriocarcinoma based on pathological examinations. Chemotherapy was started within two days after surgery, and the rate of complete remission was 100%. The mean follow-up time was 29.8±19.1 months, and no patient showed signs of relapse. Laparoscopic resection of uterine mass followed by timely postoperative chemotherapy may be an effective and safe way to obtain pathologic results in patients with suspected gestational choriocarcinoma.

Keywords: Gestational choriocarcinoma; cornual pregnancy; laparoscopy.

1

Representative laparoscopic images. Laparoscopy showed enlargement of the uterine cornual area in case 1 (A) and case 2 (B).

2

Representative histological images. Histological examinations showed myometrium invaded by atypical trophoblast with absence of chorionic villi in case 1 (A) and case 2 (B) (H&E staining, 200×).