[Choriocarcinoma after a normal pregnancy. A case report observed in Brazzaville].

Choriocarcinoma usually occurs following molar pregnancy and is uncommon following normal pregnancy. This report describes a case of choriocarcinoma in a Congolese woman 2 months after normal full-term birth of her first child. Diagnosis was suspected based on ultrasonographic findings and massive elevation of plasma beta HCG and confirmed by histologic study of placental specimens. The disease progressed rapidly despite chemotherapy and death occurred 7 months after confirmed diagnosis with multiple metastases. The incidence of choriocarcinoma after normal pregnancy is estimated to be only 0.18 cases per 1000 pregnancies in Black Africa. This low incidence increases the likelihood of late diagnosis and increases the severity of prognosis. The poor availability of antitumor drugs is a major handicap for management of these patients in developing countries. Under these conditions, the authors recommend immediate hysterectomy if metastasis has not occurred.