Choriocarcinoma of uterine cervix with cerebral and lung metastasis

Abstract

Abstract: Uterine cervical choriocarcinoma was diagnosed in a 22-years-old woman, admitted to the hospital with irregular vaginal bleeding, hemoptysis and intermittent fever for three months. She had undergone dilatation and curettage for incomplete abortion in the past and had a full term normal vaginal delivery. Pelvic examination revealed a tumor mass occupying the uterine cervix. Ultrasound of the abdomen and pelvis showed an ill defined heterogeneous predominantly isoechoic mass lesion arising from the cervical part of the uterus with invasion to the posterior wall of urinary bladder with bilateral ovarian cysts. Chest radiograph revealed multiple nodular soft tissue density radiopaque shadows of various sizes in lower zones of both lung fields. CT scan of the abdomen revealed heterogeneous soft tissue density mass lesion with central areas of hypodensities, arising from the cervical part of uterus. Fat plane with inferior wall of the bladder and rectum were lost. The mass shows heterogeneous enhancement after administration of contrast material. CT scan of head revealed multiple hemorrhagic lesions in the supratentorial compartment with perilesional edema. Urine pregnancy test was positive. Urine hCG in high dilution was also positive (upto I: 1024) and Serum B-hCG was 181.3(7) mUL/ml. Histopathological findings led to the diagnosis of choriocarcinoma of the cervix.