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KMID : 0614620230810020091
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Korean Journal of Gastroenterology
2023 Volume.81 No. 2 p.91 ~ p.94
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Primary Hepatic Choriocarcinoma with Pregnancy: A Diagnostic and Therapeutic Challenge
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Pakkala Amith Kumar
Nekarakanti Phani Kumar
Nagari Bheerappa
Bansal Ashish Kumar
Shroff Gourang
Uppin Megha S
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Abstract
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Choriocarcinoma occurs mainly in the gonads, but an extragonadal origin has been reported, albeit infrequently. Primary hepatic choriocarcinoma (PHC) is a rare malignancy, with only 11 cases reported. Most cases reported were in males, with none reported in pregnant females. A 23-year-old primigravida presented with a large liver lesion involving the right lobe of the liver at 28 weeks of pregnancy.
Preoperative imaging was suggestive of hepatocellular carcinoma. She underwent a non-anatomical resection of the liver lesion.
Surprisingly, her postoperative histopathology revealed a diagnosis of PHC. Her blood workup showed elevated beta human chorionic gonadotrophin. She underwent a termination of her pregnancy at 32 weeks. Before initiating adjuvant chemotherapy four weeks after surgery, a whole-body PET scan revealed multiple bi-lobar liver and pelvic deposits. After a multidisciplinary team discussion, she was started on adjuvant chemotherapy. She is currently under regular follow-up, seven months post-surgery. PHC, one of the vascular lesions of the liver, poses a diagnostic and therapeutic challenge, warranting a multidisciplinary approach.
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KEYWORD
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Choriocarcinoma, Liver, Pregnancy, Metastasis
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