Nongestational Choriocarcinoma Managed by Neoadjuvant Chemotherapy and Interval Surgery: A Case Report

Abstract

Ovarian cancer is the third commonest gynecological malignancy worldwide. Among ovarian cancer, epithelial carcinoma is the commonest followed by germ cell tumor. Choriocarcinoma of the ovary can be gestational or nongestational. Pure nongestational choriocarcinoma (NGCO) of the ovary is extremely rare. Histologically, it has the same appearance metastatic gestational choriocarcinoma to the ovaries. Here is a case of 15-year-old premenarchal girl referred with abdominal distension with ascites. Among her markers, beta-hCG was 860 IU/L and imaging showed a large mass with central necrosis. USG showed an ovarian mass with empty uterus. Due to her poor ECOG status, she was given etoposide + cisplatin for four cycles post-FNAC diagnosis of choriocarcinoma diagnosis. Post-neoadjuvant chemotherapy (NACT) her beta-hCG came down to be 2.16 IU/L. She subsequently underwent right salpingo-oophorectomy with surgical staging. Postoperative period was uneventful and further two cycles of etoposide + cisplatin were planned to be given. There is only a case series of 21 cases in India where NACT was given in advanced germ cell tumor followed by fertility-sparing surgery.