Advertisement

Fatal cervix rupture due to intraplacental choriocarcinoma triggered by sexual intercourse

  • Huang Weisheng
  • Wu Shuang
  • Liang Yue
  • Tong Fang
  • Dong HongmeiEmail author
  • Zhou YiwuEmail author
Case Report

Abstract

A 27-year-old woman, gravida 1 para 0, died 30 min after intercourse at the 16th week of gestation. The prenatal medical history indicated the placental implantation position at the cervix. The autopsy revealed massive hemoperitoneum and a tumor in the placenta and myometrium on the anterior right side of the cervix. A transmural perforation was found from the tumor to the serosal surface of the cervix. The autopsy, histopathology, and medical history indicated that her death was ascribed to the rupture of the cervix due to intraplacental choriocarcinoma (IC) after intercourse. The case indicated that placental implantation and tumor invasion might lead to the rupture of the uterus triggered by external forces in daily life. This case study might increase the awareness and recognition of IC.

Keywords

Forensic pathology Cervix rupture Intraplacental choriocarcinoma Sudden unexpected death 

Notes

Funding information

This study was financially supported by the open project of Evidence-Identifying Key Laboratory in Shandong Universities of Political Science and Law (Grant 2018KFKT1).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Jiao L, Ghorani E, Sebire NJ, Seckl MJ (2016) Intraplacental choriocarcinoma: systematic review and management guidance. Gynecol Oncol 141:624–631.  https://doi.org/10.1016/j.ygyno.2016.03.026 CrossRefPubMedGoogle Scholar
  2. 2.
    Seckl MJ, Sebire NJ, Berkowitz RS (2010) Gestational trophoblastic disease. Lancet 376:717–729CrossRefGoogle Scholar
  3. 3.
    Chung C, Kao MS, Gersell D (2008) Incidental placental choriocarcinoma in a term pregnancy: a case report. J Med Case Rep 2:330.  https://doi.org/10.1186/1752-1947-2-330 CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    (1965) Trophoblastic neoplasms. N Engl J Med 273:1278–1279.  https://doi.org/10.1056/nejm196512022732312
  5. 5.
    Yadav BS, Rai B, Suri V et al (2015) A young female with metastatic nongestational choriocarcinoma. Semin Oncol 42:e109–e115.  https://doi.org/10.1053/j.seminoncol.2015.09.021 CrossRefPubMedGoogle Scholar
  6. 6.
    Froeling FE, Seckl MJ (2014) Gestational trophoblastic tumours: an update for 2014. Curr Oncol Rep 16:408.  https://doi.org/10.1007/s11912-014-0408-y CrossRefPubMedGoogle Scholar
  7. 7.
    Seckl MJ, Sebire NJ, Fisher RA et al (2013) Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 24:vi39–vi50.  https://doi.org/10.1093/annonc/mdt345 CrossRefPubMedGoogle Scholar
  8. 8.
    Stichelbout M, Devisme L, Franquet-Ansart H et al (2016) SALL4 expression in gestational trophoblastic tumors: a useful tool to distinguish choriocarcinoma from placental site trophoblastic tumor and epithelioid trophoblastic tumor. Hum Pathol 54:121–126.  https://doi.org/10.1016/j.humpath.2016.03.012 CrossRefPubMedGoogle Scholar
  9. 9.
    Nagan HYS, Kohorn EI, Cole LA et al (2012) Trophoblastic disease. Int J Gynecol Obstet 119:S130–S6.  https://doi.org/10.1016/s0020-7292(12)60026-5 CrossRefGoogle Scholar
  10. 10.
    Lurain JR (2010) Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol 203:531–539.  https://doi.org/10.1016/j.ajog.2010.06.073 CrossRefPubMedGoogle Scholar
  11. 11.
    Zairi F, De Saint Denis T, Thines L, Bourgeois P, Lejeune JP (2011) Ruptured cerebral oncotic aneurysm from choriocarcinoma: report of two cases and review of the literature. Acta Neurochir 153:353–357.  https://doi.org/10.1007/s00701-010-0863-7 CrossRefPubMedGoogle Scholar
  12. 12.
    Athanassiou A, Begent RHJ, Newlands ES, Parker D, Rustin GJS, Bagshawe KD (1983) Central nervous system metastases of choriocarcinoma. 23 Years' experience at Charing Cross Hospital. Cancer 52:1728–1735CrossRefGoogle Scholar
  13. 13.
    Sekiya Y, Yamamoto E, Niimi K et al (2017) c-Rel promotes invasion of choriocarcinoma cells via PI3K/AKT signaling. Oncology 92:299–310.  https://doi.org/10.1159/000458529 CrossRefPubMedGoogle Scholar
  14. 14.
    John R, Lurain M (2010) Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol 9.  https://doi.org/10.1016/j.ajog.2010.06.073 CrossRefGoogle Scholar
  15. 15.
    Nadhan R, Vaman JV, Nirmala C et al (2017) Insights into dovetailing GTD and Cancers. Crit Rev Oncol Hematol 114:4.  https://doi.org/10.1016/j.critrevonc.2017.04.001 CrossRefGoogle Scholar
  16. 16.
    Liu J, Gou L (2006) Intraplacental choriocarcinoma in a term placenta with both maternal and infantile metastases: a case report and review of the literature. Gynecol Oncol 5.  https://doi.org/10.1016/j.ygyno.2006.08.007 CrossRefGoogle Scholar
  17. 17.
    Xie C, Zheng L, Li ZY, Zhao X (2011) Spontaneous uterine perforation of choriocarcinoma with negative beta-human chorionic gonadotropin after chemotherapy. Med Princ Pract 20:570–573.  https://doi.org/10.1159/000330028 CrossRefPubMedGoogle Scholar
  18. 18.
    Ngan HY, Seckl MJ, Berkowitz RS et al (2015) Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet 131(Suppl 2):S123–S126.  https://doi.org/10.1016/j.ijgo.2015.06.008 CrossRefPubMedGoogle Scholar
  19. 19.
    Liberis V, Bouchlariotou S, Ammari A et al (2009) Acute abdomen as initial presentation of gestational choriocarcinoma. Arch Gynecol Obstet 280:859–862.  https://doi.org/10.1007/s00404-009-0968-5 CrossRefPubMedGoogle Scholar
  20. 20.
    Brown J, Naumann RW, Seckl MJ, Schink J (2017) 15 years of progress in gestational trophoblastic disease: scoring, standardization, and salvage. Gynecol Oncol 144:200–207.  https://doi.org/10.1016/j.ygyno.2016.08.330 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Forensic Medicine, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanPeople’s Republic of China
  2. 2.Department of Forensic Medicine, Wuhan University School of Basic Medical ScienceWuhan UniversityWuhanPeople’s Republic of China

Personalised recommendations