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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 E

DOI: 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 publicationInitial presentationSite of skin lesionPrevious obstetrics historyDiagnosisOutcome
Cosnow/1974, []18 29-year-old female presented with scalp noduleSolitary nodule on scalpSpontaneous abortion 3 months agoMetastatic Choriocarcinoma to brain, liver, kidney, jejunumDied in 3 months
Erdogan/1982, []19 22-year-old nulliparous female vaginal bleedSolitary 2×3 cm nodule on R gluteal area with a small central area of necrosisSpontaneous abortion treated with dilation and curettage 5 months prior to presentationMetastatic disease with lung lesions. Primary uterine choriocarcinoma foundDied after approximately 3 months after initial presentation
Erdogan/1982, []19 31-year-old para 5-0-1-5 rectal bleed and abdominal painSolitary 3×4 cm globular mass in the left gluteal region5-0-1-5Metastatic disease with liver and small bowel masses, Bilateral adnexal massesReceived 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 bleedingScalp alopecia and facial matt-type telangiectasiaG3P30034 months post-partumMetastatic PSST. On hysterectomy, 2 mm tumor found adjacent to large vessel in the myometriumPatient did well with excision of scalp lesions and combined chemotherapy
Chama/2001, []21 40-year-old female presented with skin lesionsSoft tissue swelling under R breast and another lesion on the R shoulder –both approximately 4×4P3G3A0 Last child birth 15 yrs agoChoriocarcinoma with metastasis to chest wall, R lung and liverTreated successfully with MAC regimen
Park/2005, []10 52-year-old female presented with dyspnea2 cutaneous nodules – left side of neck and R side of upper backChoriocarcinoma with metastasis to lungs, liver, left adrenal and R kidney17 cycles of combined chemo, abd hysterectomy and bilateral oophorectomy. Adjuvant chemo planned
Afshar/2007, []13 33-year-old female presented with abnormal vaginal bleedingSolitary cutaneous lesion to the small finger of R handG1P1 History of molar pregnancy 8 years agoChoriocarcinoma with metastasis to the brain and lungs with primary in the uterusPatient 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 breathNodular lesion in scalp and ungual lesion in the left third digitG3P1 2 months prior to presentation had intrauterine fetal demise and C sectionChoriocarcinoma with metastasis to lungs, mediastinum, brain and skinPatient died 7 months after diagnosis
Razi/2011, []11 47-year-old female dyspnea with cough and upper back skin nodule2-cm diameter right-sided upper back solitary cutaneous nodule with ragged skin surfaceG4P3A1 Abortion 1 year agoChoriocarcinoma with Uterine primary and metastatic pulmonary nodulesResponded well to combination chemotherapy
Althwanay/2020 []23 55-year-old female back pain and bilateral lower extremity weaknessMultiple sacral lesions and right thigh lesionsStatus post hysterectomy 1.5 years earlier presentation due to molar pregnancyChoriocarcinoma with metastasis to liver, skin and lungsAfter an initial good response to chemotherapy patient died of septic shock
Pietrus/2021, []24 Hematuria, hemoptysis30×15 mm in size was found on the skin of the right breastEMACO Patient died after 18 months of diagnosis

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923