Pure Primary Nongestational Choriocarcinoma of the Ovary: A Case Report

Objective: Pure primary ovarian choriocarcinomas are very rare, and the nongestational type is even more uncommon. No definitive treatment protocol for this disease has been established due to its rarity. We report the case of a 21-year-old female with a pure primary nongestational choriocarcinoma of the ovary and her response to multidrug chemotherapy after surgery. Case Report: The patient received seven courses of postoperative chemotherapy with etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine (EMA/CO) after suboptimal cytoreductive surgery. Serum levels of the tumor marker !-human chorionic gonadotropin (!-HCG) dramatically decreased, and no evidence of recurrence was detected. Unfortunately, the patient died of sepsis 7 months after diagnosis. Conclusion: Pure primary nongestational choriocarcinoma is believed to have a poor prognosis. EMA/CO proved to be useful in decreasing serum !-HCG levels in our patient, but more clinical experience is required in the management of this aggressive malignancy. In addition, it is necessary to closely monitor the side effects of the chemotherapy. © 2004 Taiwan Association of Obstetric & Gynecology.