GESTATIONAL CHORIOCARCINOMA INITIALLY PRESENTING AS CORNUAL ECTOPIC PREGNANCY: A CASE REPORT

Abstract

Gestational trophoblastic neoplasia comprises a group of diseases derived from placental trophoblastic tissue, among which choriocarcinoma represents the most aggressive form, characterized by rapid hematogenous dissemination and elevated β-hCG production. We report the case of a 25-year-old woman presenting with left iliac fossa pain and positive β-hCG, initially diagnosed as a complicated cornual ectopic pregnancy and submitted to surgical treatment. Subsequently, the patient developed persistent pelvic pain associated with progressive elevation of serum β-hCG levels, reaching values above 200,000 mIU/ml. Imaging studies demonstrated a hypervascular uterine lesion and subsequent metastatic pulmonary involvement. Histopathological analysis revealed hemorrhagic tissue with scarce trophoblastic cells and absence of chorionic villi. Clinical, laboratory, and radiological correlation established the diagnosis of metastatic gestational choriocarcinoma, and chemotherapy with methotrexate and leucovorin was initiated. This case highlights the importance of considering gestational trophoblastic disease in patients with persistent or rising β-hCG levels after treatment for presumed ectopic pregnancy, emphasizing the relevance of serial follow-up and early diagnosis to improve prognosis.