AN AGGRESSIVE FORM OF CHORIOCARCINOMA

Gestational choriocarcinoma may occur as a sequel to any type of pregnancy. Choriocarcinoma is a rare trophoblastic tumor occurring approximately 50 percent after term pregnancy, 25 percent after molar pregnancy and the remainder after other gestational events. We present a case of a 22 year old lady presenting with abnormal uterine bleeding, who had a term vaginal delivery 6 months back. Evacuation was done as USG showed features suggestive of molar pregnancy. The Beta hCG levels were 20,000 mIUml. Although the levels of Beta hCG were abnormally low, the histopathology surprisingly revealed features suggestive of choriocarcinoma. The tumour then aggressively progressed to stage III within a week, but still the Beta hCG levels were around 20,000 mIUml. This case merits reporting, as in spite of its aggressive nature, low levels of Beta hCG were documented which is highly unusual in cases of post term choriocarcinomas (where the pretreatment levels are usually 1,00,000 m IUml).