[Tubal choriocarcinoma: a case]

Abstract

The authors report a case history of a tubal choriocarcinoma occurring in a woman of 38 years of age. This was 6 years after her second and last pregnancy and was diagnosed before operation. A summary of the complementary examinations is presented: An ultrasound showing a non-specific mass whose value therefore was somewhat limited; A hysterosalpingogram which showed an irregular tubal image suggestive of a cancer of the tube; Pelvic arteriography that made the signs of choriocarcinoma fairly clear. Discussion then developed in looking at the literature of those diagnostic features that are usually made. Most often this is by laparatomy when a ruptured extra-uterine pregnancy is suspected or when suspicion rests on a twisted ovarian cyst, a uterine fibroid, a tubo-ovarian abscess or blood in the peritoneal cavity in the third trimester of pregnancy, treatment, which is best given as a combination of surgery and chemotherapy, and pathogenic aetiology. It does seem that there are two principal mechanisms, the first being a malignant transformation of a tubal pregnancy, or a choriocarcinoma arising de novo without an ectopic pregnancy.