Extraovarian nongestational choriocarcinoma in a postmenopausal woman.

Primary extrauterine choriocarcinoma especially in the postmenopausal period is very rare. A 69-year-old woman, complaining of back pain, weakness, and severe fatigue with gross hematuria, was found to have paraovarian pelvic mass and underwent laparotomy. At the operation, a mass located in the right adnexal region, extending to the retroperitoneum and within the normal pathway of germ cell migration, was observed. Other peritoneal surfaces, the uterus, both the ovaries, and fallopian tubes were normal. Total abdominal hysterectomy, bilateral salphingo-oophorectomy, and excision of the right adnexal mass were performed. The histopathological report showed an extrauterine, nongonadal pure choriocarcinoma. As single-agent chemotherapy with methotrexate was ineffective, the patient received multiagent chemotherapy and responded well to the treatment. After 18 months following chemotherapy, the patient was disease free. Extraovarian nongestational choriocarcinoma can be seen within the normal pathway of germ cell migration and responds to chemotherapy-like gestational choriocarcinoma.