Metastatic vulvo vaginal choriocarcinoma mimicking a Bartholin cyst and vulvar hematoma-two unusual presentations

Metastatic choriocarcinoma may present solely as a vulvo-vaginal growth. It may pose initial diagnostic dilemmas and thus treatment delay. Two cases of metastatic choriocarcinoma which presented as vulvo-vaginal swelling are described here. Both the cases were initially misdiagnosed. Later, unresponsiveness to treatment alerted us to the possibility of metastatic choriocarcinoma. Combination chemotherapy was started following diagnosis by serum beta-HCG titer. In spite of initial responsiveness in both cases, one could not be saved due to poor compliance. Suspicion of metastatic choriocarcinoma should be kept in mind while dealing with any recent onset vulvovaginal swelling following a pregnancy. It may initially mislead the clinician due to its apparent benign appearance.