an unusual presentation of choriocarcinoma: a case report with a long latent period

Introduction: choriocarcinoma (cc) is a rare malignant tumor of trophoblastic tissue. this tends to invade rapidly to the vasculature and metastasis to the lung, vagina, brain, and liver. cc can present with a variety of manifestations, such as hemoptysis, gastrointestinal (gi) bleeding, and abnormal uterine bleeding. commonly, the latent period to the development of cc is not more than 1 year after the antecedent molar or normal pregnancy. in this report, the patient developed cc about 32 months after her previous known pregnancy. we reported a rare case of gestational cc that occurred about 32 months after her antecedent pregnancy. case presentation: a 21-year-old admitted in shock with abnormal uterine bleeding, pain, and lower abdominal pain. the patient had one previous cesarean section 32 months prior to admission. the vaginal examination demonstrated a fused solid cervical mass with an irregular border measuring about 7 × 7 cm. in further workup, there was evidence of a 103 × 94 × 89 mm mass with the hemorrhagic area and central necrosis in the middle and lower segments of the uterus and cervix. the patient underwent a total abdominal hysterectomy and left side salpingo-oophorectomy. the diagnosis of cc was made after microscopic examination. conclusions: there are few case reports of choriocarcinoma with more than a year latent period after antecedent pregnancy. the strongest hypothesis is having asymptomatic pregnancy during the period between the last pregnancy and the development of cc. however, the possibility of non-gestational choriocarcinoma in such cases should be considered. treatment with a single- or multiple-agent chemotherapy regimen should be immediately initiated after diagnosis in these cases.