[The effect of intracoronal bleaching on cervical periodontium of dogs].

BACKGROUND

Non-gestational ovarian choriocarcinomas (NGOC) are rare, distinct, highly aggressive tumors, primarily affecting young women. It accounts for less than 0.6% of malignant ovarian germ cell tumors. It is associated with a poorer prognosis compared to gestational choriocarcinoma.

CASE PRESENTATION: A 36-year-old woman (P2L2) presented with intermittent heavy menstrual bleeding for the past three months. The urinary pregnancy test was positive. On abdominal examination, a solid mass consistent with 20-weeks gravid uterus was palpated in right iliac fossa. Bimanual pelvic examination revealed uterus deviated to the left and large (~12 × 10 cm) predominantly solid mass arising from right adnexa, adherent to the uterus. A mobile cystic mass (6 × 5 cm) was palpated in the left fornix. Ultrasonography showed normal-sized uterus with no gestational sac and a well-defined, solid-cystic right adnexal mass (10.2 × 7.8 × 7.8 cm) with vascularized solid areas and hemorrhage, initially suggesting an ectopic pregnancy. Serum β-hCG was markedly elevated (262,809 mIU/mL; normal level <5.0 mIU/mL). Magnetic Resonance Imaging (MRI) and Contrast-enhanced Computed Tomography (CECT) revealed right ovarian germ cell tumor, likely choriocarcinoma, without evidence of metastatic disease. On staging laparotomy, hemorrhagic right tubo-ovarian mass (8.5 × 8 × 7 cm) and left ovarian serous cystadenoma (8 × 7 × 3.5 cm) were identified. Histopathology and genomic studies confirmed stage IA1 NGOC. Patient completed two cycles of adjuvant chemotherapy with Bleomycin, Etoposide, Cisplatin, achieving complete response (β-hCG <5 mIU/mL), and is following up with serial β-hCG monitoring and CT scans for two years.

CONCLUSIONS

NGOC closely mimics ectopic pregnancy and gestational trophoblastic disease and requires early diagnosis with prompt surgical and chemotherapeutic intervention to optimize outcomes.