Authors
Shiori Tsuge, Kosuke Yoshida, Mari Shirasaki, Hiromi Nakamura, Kaoru Niimi, Hiroaki Kajiyama
Published in
The journal of obstetrics and gynaecology research. Volume 52. Issue 8. Pages e70463.
Abstract
Intraplacental choriocarcinoma (ICC) is a rare gestational trophoblastic tumor that is often difficult to diagnose and is occasionally associated with fetomaternal hemorrhage (FMH). A 28-year-old woman presented with decreased fetal movements at 38 weeks of gestation. Due to a nonreassuring fetal heart rate pattern, an emergency cesarean section was performed. Severe neonatal anemia (3.2 g/dL) and markedly elevated maternal serum alpha-fetoprotein levels suggested FMH, despite normal maternal hemoglobin F levels. Initial placental pathology was unremarkable. Thirteen days postpartum, the patient developed massive vaginal bleeding requiring uterine artery embolization (UAE). Elevated serum β-hCG levels and multiple pulmonary nodules led to a clinical diagnosis of choriocarcinoma. Placental re-evaluation confirmed ICC. Chemotherapy with methotrexate, etoposide, and actinomycin D resulted in complete remission. In conclusion, ICC should be considered in cases of unexplained FMH or postpartum hemorrhage. UAE did not appear to impair the efficacy of subsequent chemotherapy in this case.
PMID:
42595378
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.
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