PMC5960542_01
(a) Transvaginal sonographic sagittal section of the uterus revealing no signs of intrauterine pregnancy. (b) Color Doppler and (c) power Doppler transvaginal sonographic transverse sections of the left paraovarian tumor with strong peripheral vascularization. (d) Pulsed Doppler analysis of tumor vascularization, showing a pattern of low resistance.
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When the patient was referred to our institution, her hCG level was 267,836 mIU/mL, and ultrasound showed a normal uterus, a normal left ovary, a large cystic structure on the right ovary that measured 7.5 cm x 5.5 cm, and an irregular left paraovarian mass that measured 4.6 cm x 3.7 cm and exhibited intense low-resistance peripheral vascularization on Doppler examinations (Figures 1(a) and 1(b)).
(a) T1-weighted coronal and (b) axial pelvic magnetic resonance imaging showing a cystic-solid lesion originating from the left fallopian tube (white arrow).
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Pelvic magnetic resonance imaging was performed to further evaluate the origin of these findings; this imaging confirmed the presence of a solid-cystic lesion measuring 4.5 cm x 3.2 cm with a clear cleavage interface to the left ovary and postcontrast enhancement (Figures 2(a) and 2(b)).
(a) Macroscopic appearance of the tumor. ((b) and (c)) Histological section of the tumor displaying clusters of abnormal syncytiotrophoblast and cytotrophoblast cells (hematoxylin-eosin staining, (b) x50 magnification and (c) x200 magnification).
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Pathological and immunohistochemical analyses revealed a choriocarcinoma infiltrating the tubal wall up to the serosa, the presence of vascular infiltration in tubal vessels, and a corpus luteum as the right ovarian cyst (Figure 3).
Results of genotyping of two autosomal STR loci (D13S317, D7S820) obtained from choriocarcinoma, patient, and patient's partner. The choriocarcinoma's electropherogram shows the presence of three allele for each STR loci. In the D13S317 presents the alleles 11 and 12, patient origin, and allele 11, patient's partner origin. The D7S820 presents the alleles 8 and 10, patient origin, and allele 11, patient's partner origin.
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