Open AccessChoriocarcinoma in post-menopausal women- 3 case reports with review of literature
Author(s) -
Roma Jethani,
Upasana Baruah,
Debabrata Barmon,
Dimpy Begum,
Haelom Liegise,
Megha Nandwani
Publication year - 2021
Publication title -
journal of mid-life health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.423
H-Index - 11
eISSN - 0976-7819
pISSN - 0976-7800
DOI - 10.4103/jmh.jmh_38_21
Subject(s) - medicine , choriocarcinoma , regimen , vaginal bleeding , hysterectomy , menopause , malignancy , gestational trophoblastic disease , chemotherapy , asymptomatic , gynecology , obstetrics , pregnancy , surgery , gestation , genetics , biology
Gestational trophoblastic neoplasia is of uncommon occurrence in postmenopausal women, unlike in the reproductive age group. The diagnosis is based on levels of beta-human chorionic gonadotropin (hCG) in serum. The management is similar to that in premenopausal women. First case, fifty-two-year-old, P8 L4A3 postmenopausal female, presented with postmenopausal bleeding. Diagnosis of choriocarcinoma was made in view of raised serum betah-CG levels with uterine lesion with lung metastasis. The patient started on Multi-agent chemotherapy. The patient succumbed to death due to Grade III hematological toxicity while on the first cycle of the EMA/CO regimen. Second case, forty-two-year-old, P2 L2, postmenopausal, with a history of Choriocarcinoma 20 years, back presented with postmenopausal bleeding. After metastatic workup, the patient started on EMACO regimen. She is asymptomatic and on regular follow-up after 8 cycles of chemotherapy. Third case, forty-seven-year-old, P4 L4, postmenopausal, presented with histopathology report suggestive of choriocarcinoma after hysterectomy. After evaluation, lung metastasis was detected. The patient responded to eight cycles to Multi-agent chemotherapy and is on regular follow-up. Choriocarcinoma is a rare gynecological malignancy in postmenopausal women. High index of suspicion is required for its diagnosis. The prognosis of the disease is not encouraging as compared to the premenopausal woman.