A rare case of choriocarcinoma admixed with placental site trophoblastic tumor

We report a rare case of choriocarcinoma admixed with placental site trophoblastic tumor (PSTT). The 36-year-old patient with persistent vaginal bleeding and elevated human chorionic gonadotropin (hCG) received three curretages and laparoscopic hysterectomy followed by five cycles of combination chemotherapy with EMA-CO. The serum hCG first decreased and then increased stadily companied by a possibly metastatic nodule in the lung even after hysterectomy, and the serum hCG decreased to normal level with no lesion in the lung after all intervensions. The final diagnosis was choriocarcinoma of uterus (Stage 1, Score 7) admixed with PSTT (Stage 1, without risk factors). We conclude that choriocarcinoma admixed with PSTT, especially with extensive or metastatic disease is candidate for cytoreductive surgery and chemotherapy. Pneumoperitoneum-based surgery should be considered carefully and EMA-CO may be a best choice of chemotherapy.