Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Mar 15;16(1):151-156.
doi: 10.1159/000529736. eCollection 2023 Jan-Dec.

Intraplacental Choriocarcinoma in Twin Pregnancy Causing Fetomaternal Haemorrhage and Single Twin Demise: Case Report

Catherine Schepisi  1 , Phoebe Dunsmuir  2 , Jill Lipsett  2 , Martin Klaus Oehler  1   3
Affiliations
Case Reports

Intraplacental Choriocarcinoma in Twin Pregnancy Causing Fetomaternal Haemorrhage and Single Twin Demise: Case Report

Catherine Schepisi et al. Case Rep Oncol. .

Abstract

Gestational choriocarcinoma is a rare aggressive form of gestational trophoblastic neoplasia. In cases of intraplacental choriocarcinoma, the tumour is confined to the placenta. Intraplacental choriocarcinoma in twin pregnancies is a very rare occurrence with less than 5 previously reported cases in the literature. In this case, a 34-year-old primiparous woman, pregnant with dichorionic diamniotic twins, underwent an emergency caesarean section for fetal distress at 35 weeks gestation after presenting in preterm labour. Twin A was delivered with no signs of life. The demise was attributed to fetomaternal haemorrhage (FMH) secondary to intraplacental choriocarcinoma. The mother's HCG normalised quickly postpartum with no radiological signs of metastatic disease. She has been managed conservatively with monthly HCG surveillance with no signs of recurrence. Twin B remains well with negative HCG surveillance. Although gestational choriocarcinoma can be aggressive and associated with poor obstetric outcomes, it has a good prognosis when diagnosed and treated early. The importance of detailed histopathological placental examination and clinical suspicion for choriocarcinoma following FMH is highlighted by this case.

Keywords: Choriocarcinoma; Fetomaternal haemorrhage; Gestational trophoblastic neoplasia; Twins.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Low power view of the tumour showing necrosis centrally, with sheets of atypical trophoblasts to the left and normal background placental villi to the right.
Fig. 2.
Fig. 2.
High power view of the tumour shows a triphasic cell population (a), with immunohistochemical stains for GATA-3 highlighting the cytotrophoblasts and intermediate trophoblasts (b), human chorionic gonadotrophin staining syncytiotrophoblasts (c), and human placental lactogen highlighting intermediate trophoblasts (d).
Fig. 3.
Fig. 3.
High power view of tumour illustrating the triphasic population of atypical trophoblasts.
See this image and copyright information in PMC

References

    1. Savage P, Winter M, Parker V, Harding V, Sita-Lumsden A, Fisher RA, et al. . Demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma: a UK population study. BJOG: Int J Obstet Gynaecol. 2020;127(9):1102–7. 10.1111/1471-0528.16202. - DOI - PubMed
    1. Chung C, Kao M-S, Gersell D. Incidental placental choriocarcinoma in a term pregnancy: a case report. J Med Case Rep. 2008;2(1):330–4. 10.1186/1752-1947-2-330. - DOI - PMC - PubMed
    1. Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol. 2010;203(6):531–9. 10.1016/j.ajog.2010.06.073. - DOI - PubMed
    1. Jiao L, Ghorani E, Sebire NJ, Seckl MJ. Intraplacental choriocarcinoma: systematic review and management guidance. Gynecol Oncol. 2016;141(3):624–31. 10.1016/j.ygyno.2016.03.026. - DOI - PubMed
    1. Caldas RF, Oliveira P, Rodrigues C, Reis I, Scigliano H, Nogueira R, et al. . Intraplacental choriocarcinoma: rare or underdiagnosed? Report of 2 cases diagnosed after an incomplete miscarriage and a preterm spontaneous vaginal delivery. Case Rep Med. 2017;2017:7892980. - PMC - PubMed

Publication types