# Choriocarcinoma in the Cervix: Case Report of a Challenging Differential Diagnosis

## TL;DR

A rare case of cervical choriocarcinoma is reported, emphasizing the need for thorough molecular testing to ensure accurate diagnosis and treatment.

## Contribution

This case report highlights the diagnostic challenges and the importance of molecular workup in confirming cervical gestational choriocarcinoma.

## Key findings

- Molecular analysis confirmed gestational choriocarcinoma of the cervix.
- Nonmaternal DNA was identified in the tumor tissue.
- No TP53 mutation was detected, aiding in diagnosis.

## Abstract

Primary cervical choriocarcinoma in abortion curettage tissue is extremely rare and represents a diagnostic challenge. It is a serious condition that requires prompt and targeted therapeutic management. This case report describes the diagnostic evaluation, taking into account relevant differential diagnoses and highlighting the importance of a comprehensive diagnostic work‐up to resolve these complex cases.

A 43‐year‐old woman presented with recurrent vaginal bleeding, an elevated β‐HCG of 1165 mU/mL, and sonographic suspicion of an incomplete abortion with an ectopic pregnancy in the cervix. Dilation and curettage were performed. Histological analysis raised the suspicion of a gestational choriocarcinoma of the cervix. In contrast, an external specialist referral suggested a somatic carcinoma with germ cell differentiation due to an abnormal p53 pattern, which subsequently led to a change in the management. The patient underwent a total hysterectomy and bilateral salpingo‐oophorectomy together with bilateral iliac lymphadenectomy. In the final molecular workup, nonmaternal DNA was identified in the tumor tissue. A TP53 mutation could not be detected. In summary, these findings confirmed a gestational choriocarcinoma of the cervix. Follow‐up 28 months after completion of chemotherapy revealed no evidence of recurrence.

Cervical gestational choriocarcinoma requires thorough molecular investigation, as accurate diagnosis is pivotal for optimal management.