A Rare Case of Multimetastatic Choriocarcinoma

Choriocarcinoma is a highly malignant trophoblastic tumour characterised by the secretion of human chorionic gonadotropin (β-hCG). Depending on its origin, choriocarcinoma is divided into gestational (GCC) or nongestational (NGCC). The prognosis is poor due to its high malignancy and possible hemorrhagic metastasis to distant organs. In the present case, a 40-year-old woman presented to the ophthalmology clinic with intermittent visual disturbances and a headache. An MRI of the head revealed a small, round area of contrast enhancement, suggesting a vascular malformation. A month later, the patient presented to the emergency department after syncope. A head CT scan revealed two large intracerebral hematomas, which were evacuated by craniotomy. However, there were recurrences of intracranial bleeding, some of which were reoperated. During hospitalisation, chest X-ray and CT scans revealed a mass in the right middle lobe of the lung. Successive subcapsular hematomas were detected in both liver lobes; the patient underwent two laparotomies. A gynaecological examination and transvaginal ultrasonography excluded the possibility of pregnancy despite the elevated levels of βhCG. Histopathological examination of the liver tissue confirmed the presence of metastatic foci of choriocarcinoma. The patient received cycles of chemotherapy. After chemotherapy, βhCG decreased.