Primary Bilateral Ovarian Choriocarcinoma in a 33-year-old, G3P3(3003) Female

A Case Report

Authors

  • Sarah Lizette Aquino-Cafino Zamboanga City Medical Center, Philippines https://orcid.org/0009-0005-4401-0803
  • Jose Vicente Borja II Zamboanga City Medical Center, Philippines
  • Al-Zamzam Abubakar Zamboanga City Medical Center, Philippines

DOI:

https://doi.org/10.21141/PJP.2025.05

Abstract

This is a case of a 33-year-old, G3P3(3003) female patient with a clinical presentation of vaginal bleeding associated with on and off hypogastric pain. The patient was diagnosed and managed as a case of tubo-ovarian abscess and subsequently underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAHBSO). Microscopic sections of both ovaries, however, showed dual population of tumor cells composed of medium-sized, mononucleated cells admixed with multinucleated giant cells with marked pleomorphism, extensive hemorrhage and necrosis. Immunohistochemistry studies using beta-hCG was diagnostic of ovarian choriocarcinoma, favoring non-gestational in origin. Classification of non-gestational choriocarcinoma (NGOC) was established using diagnostic criteria for NGOC established by Saito et al., and Mangla et al. DNA analysis, however, remains to be the gold-standard for differentiating between gestational (GOC) and non-gestational (NGOC) etiology.

Downloads

Download data is not yet available.

Author Biographies

Sarah Lizette Aquino-Cafino, Zamboanga City Medical Center, Philippines

Zamboanga City Medical Center, Philippines

Jose Vicente Borja II, Zamboanga City Medical Center, Philippines

Training Officer, Department of Pathology and Laboratory Medicine, Zamboanga City Medical Center, Philippines

 

Al-Zamzam Abubakar, Zamboanga City Medical Center, Philippines

Chairman, Department of Pathology and Laboratory Medicine, Zamboanga City Medical Center, Philippines

References

Goldblum JR, Lamps LW, McKenney JK, Myers JL. Choriocarcinoma. In: Rosai and Ackerman’s Surgical Pathology, 11th ed; 2018.

Talerman A, Vang R. Germ Cell Tumors of the Ovary. In: Blaustein’s pathology of the female genital tract. 6th ed. Springer; 2011. DOI: https://doi.org/10.1007/978-1-4419-0489-8_16

Mangla M, Palo S, Kanikaram P, Kaur H. Non-gestational choriocarcinoma: unraveling the similarities and distinctions from its gestational counterpart. Int J Gynecol Cancer. 2024;4(6):926-34. https://pubmed.ncbi.nlm.nih.gov/38123189 https://doi.org/10.1136/ijgc-2023-004906 DOI: https://doi.org/10.1136/ijgc-2023-004906

Magnaeva A, Asaturova A, Tregubova A, Matsneva I, Solopova A. Non-gestational choriocarcinoma of ovary: clinico-morphological features and diagnostic value of DNA polymorphism study. Hum Pathol Rep. 2022;27:000593. https://doi.org/10.1016/j.hpr.2022.300593 DOI: https://doi.org/10.1016/j.hpr.2022.300593

Hayashi S, Abe Y, Tomita S, et al. Primary non-gestational pure choriocarcinoma arising in the ovary: A case report and literature review. Oncol Lett. 2015;9(5):2109-11. https://pubmed.ncbi.nlm.nih.gov/26137022 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467297 https://doi.org/10.3892/ol.2015.2985 DOI: https://doi.org/10.3892/ol.2015.2985

Adow MT, Gebresilasie SF, Abebe NA. Primary ovarian choriocarcinoma: rare entity. Primary ovarian choriocarcinoma: rare entity. Case Rep Obstet Gynecol. 2021;2021:4545375. https://pubmed.ncbi.nlm.nih.gov/34608421 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8487380 https://doi.org/10.1155/2021/4545375 DOI: https://doi.org/10.1155/2021/4545375

Cronin S, Ahmed N, Criag AD, et al. Non-gestational ovarian choriocarcinoma: a rare ovarian cancer subtype. Diagnostics (Basel). 2022;12(3):560. https://pubmed.ncbi.nlm.nih.gov/35328112 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947355 https://doi.org/10.3390/diagnostics12030560 DOI: https://doi.org/10.3390/diagnostics12030560

Euscher ED, Liu A, Rabban JT. Non-gestational choriocarcinoma. In: WHO Classification of Tumours Editorial Board, ed. WHO classification of tumours: female genital tumours. 5th ed. Vol 4. International Agency for Research on Cancer; 2020.

Chongco- Angeles UL, Tolentino, A, Gaddi A. Non-gestational ovarian choriocarcinoma: a rare encounter. Philipp J Obstet Gynecol. 2001;25(1):22-8.

Mood NI, Samadi N, Rahimi-Moghaddam P, Sarmadi S, Eftekhar Z, Yarandi F. Pure ovarian choriocarcinoma: report of two cases. J Res Med Sci. 2009;14(5):327-30. https://pubmed.ncbi.nlm.nih.gov/21772904 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129104

Ali TZ, Parwani AV. Current concepts in genitourinary pathology: kidney and testes. Surg Pathol Clin. 2009;2(1):61-159. https://doi.org/10.1016/j.path.2008.08.007 DOI: https://doi.org/10.1016/j.path.2008.08.007

Gilks B. Ovary. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman’s Surgical Pathology. 11th ed. Elsevier; 2018.

Zhong Y, Chen X, Huang Y, et al. Ovarian high-grade serous carcinoma with elevated β-human chorionic gonadotropin. Medicine (Baltimore). 2021;100(51):e28144. https://pubmed.ncbi.nlm.nih.gov/34941061 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702252 https://doi.org/10.1097/MD.0000000000028144 DOI: https://doi.org/10.1097/MD.0000000000028144

Edmund LN, Salama AM, Murali R. Cytologic features of sex cord-stromal tumors in women. Cancer Cytopathol. 2022;130(1):55-71. https://pubmed.ncbi.nlm.nih.gov/34411449 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439705 https://doi.org/10.1002/cncy.22502 DOI: https://doi.org/10.1002/cncy.22502

Miettinen M, Wang Z, McCue PA, et al. SALL4 expression in germ cell and non-germ cell tumors: a systematic immunohistochemical study of 3215 cases. Am J Surg Pathol. 2014;38(3):410-20. Phttps://pubmed.ncbi.nlm.nih.gov/24525512 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041084 https://doi.org/10.1097/PAS.0000000000000116 DOI: https://doi.org/10.1097/PAS.0000000000000116

Lan L, Luo Y, Zhou M, et al. Comparison of diagnostic accuracy of thyroid cancer with ultrasound-guided fine-needle aspiration and core-needle biopsy: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2020;11:44. https://pubmed.ncbi.nlm.nih.gov/32117069 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033392 https://doi.org/10.3389/fendo.2020.00044 DOI: https://doi.org/10.3389/fendo.2020.00044

Saito M, Azuma T, Nakamura K. On ectopic choriocarcinoma. World Obstet Gynecol. 1963;17:459–84.

Rabban J, Euscher E, Liu A. Non gestational choriocarcinoma. In: WHO Classification of Tumours: Female Genital Tumours. 5th ed, Vol 4. Lyon, France: International Agency for Research on Cancer; 2020.

Cheung ANY, Shen DH, Khoo US, Wong LC, Ngan HYS. p21WAF1/CIP1 expression in gestational trophoblastic disease: correlation with clinicopathological parameters, and Ki67 and p53 gene expression. J Clin Pathol. 1998;51(2):159–62. https://pubmed.ncbi.nlm.nih.gov/9602692 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC500513 https://doi.org/10.1136/jcp.51.2.159 DOI: https://doi.org/10.1136/jcp.51.2.159

Sui MKY, Wong ESY, Chan HY, Ngan HYS, Chan KYK, Cheung ANY. Overexpression of NANOG in gestational trophoblastic diseases: effect on apoptosis, cell invasion, and clinical outcome. Am J Pathol. 2008;173(4):1165-72. https://pubmed.ncbi.nlm.nih.gov/18772339 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2543083 https://doi.org/10.2353/ajpath.2008.080288 DOI: https://doi.org/10.2353/ajpath.2008.080288

Downloads

Published

06/21/2025

How to Cite

Aquino-Cafino, S. L., Borja II, J. V., & Abubakar, A.-Z. (2025). Primary Bilateral Ovarian Choriocarcinoma in a 33-year-old, G3P3(3003) Female: A Case Report. The Philippine Journal of Pathology, 10(1), 31–36. https://doi.org/10.21141/PJP.2025.05

Issue

Vol. 10 No. 1 (2025): June Issue (Online)

Section

Case Reports

License

Copyright (c) 2025 Sarah Lizette Aquino-Cafino, Jose Vicente Borja II, Al-Zamzam Abubakar

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.