A recurrent gestational choriocarcinoma case complicated by a silent postpartum ruptured uterus: a unique presentation

Abstract

Gestational trophoblastic diseases comprise of potentially malignant conditions arising from defective proliferation of trophoblastic tissue. Among the different types, gestational choriocarcinoma constitutes a malignant form with significant cure rate and minimal sequel if treated adequately and followed up consistently. In this case report, we describe a patient who previously had history of choriocarcinoma and was treated with six courses of combination chemotherapy and was not followed up consistently and 14 months later conceived and delivered a live 1.3 kg female baby at 31 weeks of gestation. Two weeks post-delivery she was diagnosed with ruptured uterus. Long term complication following choriocarcinoma is a rare event. Moreover, coexistence of choriocarcinoma with normal pregnancy and a subsequent ruptured uterus two week after delivery constitutes an atypical presentation. Complications and challenges described in this report highlight some of the difficulties encountered in managing gestational trophoblastic neoplasia in limited resource setting of Tanzania.