Choriocarcinoma of the uterus following term live birth

Early diagnosis of gestational choriocarcinoma is important as it is potentially curable with appropriate chemotherapy. The authors report the case of 29-year-old woman who presented at six weeks following a term live vaginal delivery with persistent irregular vaginal bleeding. Her pregnancy test was positive on admission and serum hCG was 91,470 IU/L. Ultrasound scan showed the possibility of retained products of conception. The patient underwent surgical evacuation of retained products of conception after multidisciplinary team (MDT) discussion and histology confirmed the diagnosis of choriocarcinoma. The patient was then referred to regional trophoblastic disease centre. She had staging investigations and was given a FIGO score of 4. She received four doses of methotrexate and then required two doses of intravenous carboplatin after a secondary rise in hCG levels.