Spontaneous Uterine Perforation in a Choriocarcinoma Presenting with Pyoperitoneum

Kameshwarachari Pushpalatha; Bharti Singh; Anusha Devalla; Sashmi Sasidharan; Hemlata Panwar

doi:10.5005/jp-journals-10006-1946

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Spontaneous Uterine Perforation in a Choriocarcinoma Presenting with Pyoperitoneum

Kameshwarachari Pushpalatha, Bharti Singh, Anusha Devalla, Sashmi Sasidharan, Hemlata Panwar

Keywords : Acute abdomen, Choriocarcinoma, Laparotomy, Pyoperitoneum, Uterine perforation

Citation Information : Pushpalatha K, Singh B, Devalla A, Sasidharan S, Panwar H. Spontaneous Uterine Perforation in a Choriocarcinoma Presenting with Pyoperitoneum. J South Asian Feder Obs Gynae 2021; 13 (4):272-274.

DOI: 10.5005/jp-journals-10006-1946

License: CC BY-NC 4.0

Published Online: 20-11-2021

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Abstract

Aim and objective: Choriocarcinoma can have intricate presentations and pose challenges in management. We are presenting a rare case of spontaneous uterine perforation in a choriocarcinoma. Background: Choriocarcinoma is a rare neoplasm with varied incidence worldwide. It is a highly malignant tumor of trophoblastic tissue. Case description: We present a case of 29-year-old multiparous women admitted with fever and foul-smelling vaginal discharge. After 2 days of admission, she developed features of perforation peritonitis. She was taken up for emergency laparotomy. Hysterectomy was performed in view of perforation of uterus with extensive necrosis. Peritoneal cavity was filled with pus. The histopathological examination revealed choriocarcinoma. Her serum beta-human chorionic gonadotropin (hCG) was 2397 mIU/mL. She received multiagent chemotherapy (EMA/CO) for six cycles till the beta-hCG values came to normal. On 1 year follow-up, the beta-hCG values remained normal. Conclusion: Choriocarcinoma presenting with acute abdomen and pyoperitoneum is a rare clinical presentation and should be a kept as a diagnosis of exclusion. Clinical significance: Timely diagnosis and management can improve the clinical prognosis of the patients.

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Fisher RA, Savage PM, MacDermott C, et al. The impact of molecular genetic diagnosis on the management of women with hcg-producing malignancies. Gynecol Oncol 2007;107(3):413–419. DOI: 10.1016/j.ygyno.2007.07.081.
O'Neill CJ, Houghton F, Clarke J, et al. Uterine gestational choriocarcinoma developing after a long latent period in a postmenopausal woman: the value of DNA polymorphism studies. Int J Surg Pathol 2008;16(2):226–229. DOI: 10.1177/1066896907307038.
Liberis V, Bouchlariotou S, Ammari A, et al. Acute abdomen as initial presentation of gestational choriocarcinoma. Arch Gynecol Obstet 2009;280(5):859–862. DOI: 10.1007/s00404-009-0968-5.
Ma Y, Xiang Y, Wan XR, et al. The prognostic analysis of 123 postpartum choriocarcinoma cases. Int J Gynecol Cancer 2008;18(5):1097–1101. DOI: 10.1111/j.1525-1438.2007.01132.x.

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