Metastatic Choriocarcinoma as a Complication of Pregnancy

A 29-year-old gravida 2 had an intraabdominal hemorrhage from hepatic metastases of choriocarcinoma during Gestational Week 29. Cesarean section was performed. The primary tumor found in the wall of the uterus had no connection with the placenta. Treatment with methotrexate did not save the patient who died on the eleventh day post partum. The child, who developed respiratory distress syndrome, died 5 hrs after birth. At autopsy, metastases were found in the liver and lungs of the mother; no signs of tumor growth were found in the child. Hypotheses for an explanation of the occurrence of choriocarcinoma and intrauterine pregnancy are discussed; it seems unlikely that this tumor can be influenced immunologically. Previous reports of the combination are reviewed.