Severe Lower Gastrointestinal Bleeding Due to Choriocarcinoma with
AVM to the Ileum: A Case Report

Malihe      Hasanzadeh; Najmeh      Jahani; Farzaneh      Khoroushi; Nourieh      Sharifi

doi:10.2174/15734048176662110071010

Abstract

Background: Choriocarcinoma and other placental tumors are rare, and metastasis to the gastrointestinal, especially the small bowel, is extremely rare. Furthermore, about 5% of all metastasis belongs to the GI tract.

Case Presentation: We reported an 18 -year-old patient with severe GI bleeding. Serum BHCG level was 57322 mIU/mL. CT angiography and Pelvic MRI suggested a metastatic arteriovenous malformation to the small bowel. In surgery, we detected the AVM from the right side of the uterus to the ileum, and pathological findings confirmed the choriocarcinoma with metastatic AVM to the ileum.

Conclusion: Chemotherapy started after surgery, and the patient was asymptomatic on follow-up after 14 months. The results showed that GTN was a differential diagnosis when patients are referred with these signs and symptoms.

Keywords: Arteriovenous malformation, Case report, Choriocarcinoma, Gastrointestinal bleeding, Gestational trophoblastic neoplasia, metastatic.

Graphical Abstract

[1]
Mangla, M.; Singla, D.; Kaur, H.; Sharma, S. Unusual clinical presentations of choriocarcinoma: A systematic review of case reports. Taiwan. J. Obstet. Gynecol.,  2017, 56(1), 1-8.
 [http://dx.doi.org/10.1016/j.tjog.2015.05.011] [PMID:  28254207]

[2]
Meddeb, S.; Rhim, M.S.; Zarrouk, W.; Bibi, M.; Yacoubi, M.T.; Khairi, H. Unusual gestational choriocarcinoma arising in an interstitial pregnancy. Int. J. Surg. Case Rep.,  2014, 5(11), 787-788.
 [http://dx.doi.org/10.1016/j.ijscr.2014.08.025] [PMID:  25290382]

[3]
Cho, E.B.; Byun, J.M.; Jeong, D.H.; Yoon, H.K.; Kim, Y.N.; Sung, M.S.; Lee, K.B.; Kim, K.T. Metastatic choriocarcinoma as initial presentation of small bowel perforation in absence of primary uterine lesion: A case report. Tumori,  2016, 102(2_suppl)(Suppl. 2), 587-589.
 [http://dx.doi.org/10.5301/tj.5000379] [PMID:  26166218]

[4]
Fatemi, S.R.; Ehsani Ardakani, M.J.; Mohsenifar, Zh.; Zali, M.R. A case report of metastatic choriocarcinoma to jejunum with severe lower GI bleeding. Govaresh J.,  2004, 9(3), 194-196.

[5]
Hassadia, A.; Kew, F.M.; Tidy, J.A.; Wells, M.; Hancock, B.W. Ectopic gestational trophoblastic disease: A case series review. J. Reprod. Med.,  2012, 57(7-8), 297-300.
 [PMID:  22838244]

[6]
Iyomasa, S.; Senda, Y.; Mizuno, K.; Miyake, H.; Amemiya, T.; Yamaguchi, J.; Suzuki, K.; Matsuda, M. Primary choriocarcinoma of the jejunum: Report of a case. Surg. Today,  2003, 33(12), 948-951.
 [http://dx.doi.org/10.1007/s00595-003-2626-z] [PMID:  14669091]

[7]
Cain, A.; Kost, E.; Hall, K.; Bell, K.; Mankus, E.; Murray, A.; McCann, G. Pulmonary arterial venous malformations as primary manifestation of gestational trophoblastic neoplasia. Gynecol. Oncol. Rep.,  2020, 34, 100635.
 [http://dx.doi.org/10.1016/j.gore.2020.100635] [PMID:  32984494]

[8]
Touhami, O.; Gregoire, J.; Noel, P.; Trinh, X.B.; Plante, M. Uterine arteriovenous malformations following gestational trophoblastic neoplasia: A systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol.,  2014, 181, 54-59.
 [http://dx.doi.org/10.1016/j.ejogrb.2014.07.023] [PMID:  25126982]

[9]
Fatemi, S.R.; Hatami, B.; Ghobakhlou, M. Severe lower gastrointestinal bleeding due to metastatic choriocarcinoma to the jejunum: A rare presentation. J. Gastroenterol. Dig. Dis.,  2017, 2(1), 22-24.

[10]
Yosefi, Z.; Ghasemian, S.; Farimany, M.; Fakari, F. Metastatic choriocarcinoma in the small bowel: A case report. Tehran Univ. Med. J.,  2014, 72(5), 335-339.

Rights & Permissions Print Cite

Journal Information

For Authors

For Editors

For Reviewers

Explore Articles

Open Access

Open Access Articles

For Visitors

DOI https://dx.doi.org/10.2174/15734048176662110071010	Print ISSN 1573-4048
Publisher Name Bentham Science Publisher	Online ISSN 1875-6581

Current Women`s Health Reviews

Severe Lower Gastrointestinal Bleeding Due to Choriocarcinoma with AVM to the Ileum: A Case Report

Abstract Play Pause

Graphical Abstract

Abstract