Successful treatment of choriocarcinoma with multiple organ metastases after term delivery: a case report

We describe a case of choriocarcinoma with multiple organ metastases after term delivery. A 43-year-old female was diagnosed as choriocarcinoma with metastases to the liver, lungs, marrow cavity, thoracic vertebra and brain, based on serum levels of β-human chorionic gonadotrophin (β-hCG), clinical symptoms, gynecological examination, PET/CT examination and medical histories. Fourteen courses of FAV (5-fluorouracil (5-FU), dactinomycin and vincristine) and three courses of intrathecal methotrexate chemotherapy were administrated, accompanied with panhysterectomy, cholecystectomy and partial resection of the right liver lobe. After 30 months of hospital discharge, brain, lung, liver and bone metastases were not found, and blood β-hCG stayed within the normal range. Choriocarcinoma should be taken into consideration in reproductive-age women when associated symptoms and significantly elevated blood levels of β-hCG were identified. Combined chemotherapy accompanied with surgical resection is an effective strategy to treat choriocarcinoma patients with multiple organ metastases.