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1195 Non-gestational uterine choriocarcinoma in postmenopausal women
  1. Celal Akdemir,
  2. Halil Ibrahim Yildiz,
  3. Serkan Karaoglu,
  4. Zeliha Öcal,
  5. Özgür Erdogan,
  6. Tugba Karadeniz,
  7. Taha Resid Özdemir,
  8. Ayhan Gül and
  9. Muzaffer Sanci
  1. Tepecik Training and Research Hospital, Izmir, Turkey


Introduction/Background Choriocarcinoma is a rare tumor with a very high invasion capacity, characterized by the proliferation of cytotrophoblastic and syncytiotrophoblastic layers, the absence of chorionic villi. Choriocarcinoma is basically divided into two: gestational choriocarcinoma (GC) and non-gestational choriocarcinoma (NGC).

Methodology In the radiological evaluation of our 49-year-old patient, a lesion limited to the uterus was detected. The biopsy was compatible with choriocarcinoma. No metastasis was detected on imaging. The patient was evaluated as stage I according to FIGO 2020 staging. The patient‘s β-HCG value before treatment was determined as 27,000. EMA-CO protocol was planned for the patient. 3 cures of EMA-CO were given. The patient had β-HCG measured every 14 days. The patient, whose disease was considered stable during follow-up, was considered resistant to treatment. Paternal contribution was investigated with the STR (Short Tandem Repeat) test planned for the patient before treatment. As a result of the test, it was determined that the DNA structure of paternal origin was different from the tumor DNA. The patient was accepted as NGC.

Results Hysterectomy was performed because the patient was resistant to treatment. Postoperatively, platinum-based treatment was planned (BEP). However, during this period, the patient‘s general condition deteriorated. During the patient‘s follow-up, multiple metastases were detected in his lungs. The patient died 6 months after diagnosis.

Conclusion It is very important to type choriocarcinoma in order to inform the patient about these two diseases, which are very difficult to distinguish histopathologically but have different prognoses, and to correctly manage the treatment process together with the patient. For this reason, only the presence of paternal genes in the tumor tissue becomes important in making the distinction. STR method, one of the most commonly used tests today, is the most important method in searching for paternal gene traces in the tumor.

Disclosures There is no conflict of interest between the authors of the article.

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