Abstract:

Choriocarcinoma is a highly malignant type of trophoblastic tumor, and cases of choriocarcinoma detected after preterm cesarean section are rare. This report details a case of choriocarcinoma discovered following a preterm cesarean section. The patient underwent a lower segment cesarean section due to poor fetal heart monitoring, an abnormal S/D ratio in the umbilical artery on fetal ultrasound, and elevated alpha-fetoprotein levels. After birth, the newborn was diagnosed with anemia. The patient experienced persistent abnormal vaginal bleeding for more than a month post-cesarean section. A follow-up test revealed elevated levels of β-human chorionic gonadotropin (β-hCG), and ultrasound showed an abnormal intrauterine echo mass. After excluding retained products of conception and new pregnancy, and considering the patient′s history, clinical presentation, specialized examinations, and auxiliary tests, the diagnosis of choriocarcinoma was made. The patient was treated with three courses of fluorouracil and methotrexate chemotherapy from day 1 to day 8, and the follow-up β-hCG level decreased to 4.13 IU/L. Both mother and child had a favourable outcome as of the follow-up in May 2024. Therefore, regardless of whether the patient has a full-term pregnancy, abnormal postpartum vaginal bleeding and abnormal β-hCG levels in postpartum women should raise suspicion for gestational trophoblastic tumors. Early diagnosis and treatment, along with regular follow-up after chemotherapy, are crucial.

Key words: Choriocarcinoma, Trophoblastic neoplasms, Premature birth, Caesarean section