Abstract:

Choriocarcinoma is a highly malignant gestational trophoblastic tumor that is prone to early metastasis. Cesarean scar pregnancy complicated with choriocarcinoma lacks specific clinical symptoms, is extremely rare clinically, and is easily misdiagnosed in the early stage. Early diagnosis and treatment are crucial for the prognosis. A case of cesarean scar pregnancy complicated with choriocarcinoma is reported. The patient was admitted to the hospital due to amenorrhea for 59 days accompanied by vaginal bleeding for 2 days. After hysteroscopic removal of the scar pregnancy tissue, the pathological diagnosis was cesarean scar pregnancy. After the operation, the serum level of β-human chorionic gonadotropin (β-hCG) decreased and then abnormally increased again. Ultrasound showed an abnormal echo mass at the scar site, and gestational trophoblastic disease was suspected. After laparoscopic resection of the cesarean scar pregnancy lesion, the pathological diagnosis was choriocarcinoma. After two courses of chemotherapy with the fluorouracil + actinomycin-D + vincristine (FAV) regimen, the patient's blood β-hCG turned negative. Transvaginal ultrasound showed no abnormal mass. The patient had no recurrence during the 11-month follow-up after the end of chemotherapy.

Key words: Cesarean section, Cicatrix, Pregnancy, Choriocarcinoma, Methotrexate, Laparoscopy