RAMAZAN ESEN, Nurlan MAMMADZADA, Birol YILDIZ, NURİ KARADURMUŞ

Primary vulvovaginal choriocarcinoma patient who underwent autologous hematopoetic stem cell transplantation: A case report of unusual presentation

Ovarian germ cell tumors (GCT) are derived from primordial germ cells of the ovary. Choriocarcinomas are more commonly of placental than ovarian origin in a woman. Vaginal choriocarcinoma is seen very rare in the literature. If the germ cell tumors are relapsed or refractory to the salvage chemotherapy, autologous hematopoietic stem cell transplantation (AHSCT) can be used for the treatment. Our aim is to present a rare vaginal choriocarcinoma patient who underwent AHSCT due to the relapsed disease. A 46-year-old woman who had two vaginal deliveries 18 years ago, presented with a vaginal mass. The diagnosis was made as choriocarcinoma after abscess drainage. Due to the elevated levels of β-HCG, she had undergone chemotherapy. After the four lines chemotherapy serum tumor markers remained high. Because of that reason, AHSCT was performed and after the transplantation, the β-HCG level has decreased. The patient was observed with a very good partial response. According to current literature, AHSCT is a reasonable treatment option for relapsed or resistant cases. In conclusion, our case is the first and unique who has undergone AHSCT. AHSCT is an effective and tolerable treatment for ectopic relapsed and refractory choriocarcinoma cases.

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Yildiz, Birol, Erturk I, et al. "Prognostic value of ABO blood group in patients with nonseminomatous testicular cancer who treated with autologous stem cell transplantation." Journal of Oncological Sciences 2018; 4: 70-73.

Erdem, Gokhan, Karadurmus N, et al. "Assessment of the efficiency of Brentuximab Vedotin in patients with pulmonary Hodgkin Lymphoma by the mean of neutrophil to lymphocyte ratio." Journal of Oncological Sciences 2018; 4: 29-34.

Andersson S, Rylander E, Flam F. Choriocarcinoma presented as a vaginal tumor. Acta obstetricia et gynecologica Scandinavica 2004; 83: 776-777.

Bangal VB, Shinde KK, Gavhane SP, Singh RK. Gestational Choriocarcinoma of uterus with vaginal metastasis. International Journal of Biomedical and Advance Research 2013; 4: 137- 139.

Erbil Karaman, Orkun Çetin, Ali Kolusari, and Irfan Bayram, Primary Tubal horiocarcinoma Presented as Ruptured Ectopic Pregnancy J Clin Diagn Res 2015; 9: 17-18.

Bhattacharyya SK, Saha SP, Mukherjee G, Samanta J. Metastatic vulvo-vaginal choriocarcinoma mimicking a Bartholin cyst and vulvar hematomatwo unusual presentations. Journal of the Turkish German Gynecological Association 2012; 13: 218-220.

Sonobe H, Taguchi K, Ogawa K, Yoshioka T. Latent vaginal choriocarcinoma in a postmenopausal woman. Acta Pathologica Japonica 1976; 26: 611-618.

Einhorn LH, Williams SD, Chamness A, Brames MJ, Perkins SM, Abonour R. High dose chemotherapy and stem cell rescue for metastatic germ cell tumors. N Engl J Med 2007; 357: 3408.

Goldberg GL, Yon DA, Bloch B, Levin W. Gestational trophoblastic disease: the significance of vaginal metastases. Gynecol Oncol 1986; 24: 155-161.

Ghaemmaghami F, Behroozi S, Mousavi A, Ashrafgangooei T, Gilani MM, Behtash N, et al. Assessment of the response to chemotherapy in gestational trophoblastic neoplasia with vaginal metastases. Arch Gynecol Obstet 2008; 278: 315- 318.

Lurain JR, Singh DK, Schink JC: Primary treatment of metastatic high-risk gestational trophoblastic neoplasia with EMA-CO chemotherapy. J Reprod Med 2006, 51: 767-772.