Article Text

Download PDFPDF
Non-gestational uterine choriocarcinoma inside a leiomyoma: importance of early suspicion in prognosis
  1. Filipa Mendes Coutinho1,2,
  2. Sofia Raposo2,
  3. Teresa Carvalho3 and
  4. Rita Sousa2
  1. 1Gynecology Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  2. 2Gynaecology, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
  3. 3Oncology, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Filipa Mendes Coutinho; filipa.mendes.coutinho{at}


Uterine choriocarcinoma is a trophoblastic neoplasm most commonly related to pregnancy. However, there are already cases of non-gestational uterine choriocarcinoma (NGC) described in literature. The difficult diagnosis may delay treatment and threaten patient survival. We report the case of a 37-year-old patient presenting with abnormal haemorrhage and moderate levels of beta-human chorionic gonadotropin (β-hCG). As imaging exams did not show any suspicious site for the origin, choriocarcinoma was not considered so the treatment was delayed. Anatomopathological diagnosis was given both from the surgical sample of hysterectomy and from a skin lesion. The lesion was discovered inside a myoma. At this point, β-hCG levels were substantially high and she presented with respiratory distress due to pulmonary metastasis. The patient was transferred to an intensive care unit and underwent mechanical ventilation as well as life-saving chemotherapy. At 10 months after diagnosis, she is well and in remission. The delay from not suspecting the diagnosis was almost fatal for the patient.

  • cancer intervention
  • obstetrics
  • gynaecology and fertility
  • adult intensive care
  • cancer - see oncology
  • carcinogenesis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors FMC: conception, data collection, drafting of the article. SR: attending physician, critical revision of the article. RS: final approval of the version to be published. TC: attending physician, final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.