18 June 2022: Articles
A Rare Case of Combined Choriocarcinoma and Placental Site Trophoblastic Tumor Presenting as Skin Lesion: A Case Report
Unusual clinical course, Challenging differential diagnosis
Tulika Chatterjee E* , Annia Martial E , Sahitya Settypalli E , Larry Lindahl EDOI: 10.12659/AJCR.936451
Am J Case Rep 2022; 23:e936451
Table 1. List of previously reported cases of gestational choriocarcinoma with skin metastasis.
| Author/Year of publication | Initial presentation | Site of skin lesion | Previous obstetrics history | Diagnosis | Outcome |
|---|---|---|---|---|---|
| Cosnow/1974, []18 | 29-year-old female presented with scalp nodule | Solitary nodule on scalp | Spontaneous abortion 3 months ago | Metastatic Choriocarcinoma to brain, liver, kidney, jejunum | Died in 3 months |
| Erdogan/1982, []19 | 22-year-old nulliparous female vaginal bleed | Solitary 2×3 cm nodule on R gluteal area with a small central area of necrosis | Spontaneous abortion treated with dilation and curettage 5 months prior to presentation | Metastatic disease with lung lesions. Primary uterine choriocarcinoma found | Died after approximately 3 months after initial presentation |
| Erdogan/1982, []19 | 31-year-old para 5-0-1-5 rectal bleed and abdominal pain | Solitary 3×4 cm globular mass in the left gluteal region | 5-0-1-5 | Metastatic disease with liver and small bowel masses, Bilateral adnexal masses | Received MAC therapy (Mtx, actinomycin D, Cytoxan). Patient survived |
| Yu-Pahn Yuen/1998, []20 | 31-year-old female presented with patchy hair loss and persistent post-partum vaginal bleeding | Scalp alopecia and facial matt-type telangiectasia | G3P30034 months post-partum | Metastatic PSST. On hysterectomy, 2 mm tumor found adjacent to large vessel in the myometrium | Patient did well with excision of scalp lesions and combined chemotherapy |
| Chama/2001, []21 | 40-year-old female presented with skin lesions | Soft tissue swelling under R breast and another lesion on the R shoulder –both approximately 4×4 | P3G3A0 Last child birth 15 yrs ago | Choriocarcinoma with metastasis to chest wall, R lung and liver | Treated successfully with MAC regimen |
| Park/2005, []10 | 52-year-old female presented with dyspnea | 2 cutaneous nodules – left side of neck and R side of upper back | Choriocarcinoma with metastasis to lungs, liver, left adrenal and R kidney | 17 cycles of combined chemo, abd hysterectomy and bilateral oophorectomy. Adjuvant chemo planned | |
| Afshar/2007, []13 | 33-year-old female presented with abnormal vaginal bleeding | Solitary cutaneous lesion to the small finger of R hand | G1P1 History of molar pregnancy 8 years ago | Choriocarcinoma with metastasis to the brain and lungs with primary in the uterus | Patient died after 1 year after the appearance of cutaneous metastasis |
| Mendez/2009, []22 | 29-year-old female presented with persistent vaginal bleeding after C section followed by shortness of breath | Nodular lesion in scalp and ungual lesion in the left third digit | G3P1 2 months prior to presentation had intrauterine fetal demise and C section | Choriocarcinoma with metastasis to lungs, mediastinum, brain and skin | Patient died 7 months after diagnosis |
| Razi/2011, []11 | 47-year-old female dyspnea with cough and upper back skin nodule | 2-cm diameter right-sided upper back solitary cutaneous nodule with ragged skin surface | G4P3A1 Abortion 1 year ago | Choriocarcinoma with Uterine primary and metastatic pulmonary nodules | Responded well to combination chemotherapy |
| Althwanay/2020 []23 | 55-year-old female back pain and bilateral lower extremity weakness | Multiple sacral lesions and right thigh lesions | Status post hysterectomy 1.5 years earlier presentation due to molar pregnancy | Choriocarcinoma with metastasis to liver, skin and lungs | After an initial good response to chemotherapy patient died of septic shock |
| Pietrus/2021, []24 | Hematuria, hemoptysis | 30×15 mm in size was found on the skin of the right breast | EMACO Patient died after 18 months of diagnosis |