Choriocarcinoma in a postmenopausal woman

BACKGROUND: Choriocarcinoma typically occurs within 12 months of pregnancy but rarely may present many years after an antecedent pregnancy. This report describes choriocarcinoma in a postmenopausal woman. CASE: A 62-year-old woman presented with dyspnea, a history of postmenopausal vaginal spotting, and metastatic disease on chest X-ray. A transvaginal ultrasonogram revealed a thickened endometrium. Endometrial biopsy and an elevated beta-hCG confirmed the diagnosis of metastatic choriocarcinoma. Multiagent chemotherapy was initiated, and the patient developed fatal toxic epidermal necrolysis. CONCLUSION: This case reminds practitioners that choriocarcinoma can occur in postmenopausal women, and although cure rates are high, deaths occasionally occur because of toxicity associated with treatment.