Diagnostic Error in Postpartum Choriocarcinoma: A case report

Abstract

Introduction: Choriocarcinoma is one of the rare diseases of gestational trophoblastic tumor with various and sometimes misleading clinical presentations. Clinical suggestion of the disease and timely diagnosis can be useful. The aim of this study is to report a case of diagnostic medical error in postpartum choriocarcinoma. Case report: A 25-year-old woman with prolonged postpartum hemorrhage referred to the hospital in one of the cities around Mashhad. Despite frequent referring of the patient due to bleeding, and not considering laboratory signs and sonography and increased levels of βhCG, gestational trophoblastic tumor was not diagnosed. It led to uterus rupture. Then, with emergency situation due to uterus rupture, multiple lung and brain metastases, she was referred to the gynecologic oncology ward in 2017. Currently, she is under chemotherapy without need to surgery. Conclusion: The possibility of choriocarcinoma should be considered in every woman of reproductive age with postpartum abnormal uterine bleeding and also bleeding from other organs or diagnosis of metastasis with unknown etiology.

Keywords

• abnormal uterine bleeding
• choriocarcinoma
• diagnostic error
• gestational trophoblastic disease
• postpartum vaginal hemorrhage