Author/Authors :
Azimi, Helena Department of Obstetrics and Gynecology - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Shirinzadeh, Laya Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Jafarian, Amir Hosein Department of Pathology - School of Medicine - Ghaem Hospital - Mashhad University of Medical Sciences, Mashhad, Iran , Davachi, Behrouz Department of Radiology - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Bolandi , Somayeh Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Hoseini, Sepide Department of Obstetrics and Gynecology - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Zavari, Tahereh Department of Midwifery - School of Nursing and Midwifery - Mashhad University of Medical Sciences, Mashhad, Iran , Yousefi, Zohreh Department of Obstetrics and Gynecology - Fellowship of Gynecologic Oncology - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Shirzadeh, Fatemeh Department of Nursing - School of Nursing and Midwifery - Mashhad University of Medical Sciences, Mashhad, Iran
Abstract :
Background & aim: Cesarean scar pregnancy is an ectopic pregnancy implanted in
the myometrium at the site of a previous cesarean section scar and is the rarest kind
of ectopic pregnancy. The present study present a case of choriocarcinoma (CC) in
the cesarean scar. The clinical course, findings, and treatment plan are discussed.
Case report: A 41-years old multi-gravid woman with a history of one previous
cesarean section and three subsequent abortions was admitted to the hospital. She
suffered from an unknown abnormal vaginal bleeding for two months. Β-HCG titer
was 1,000 IU/L and the report of sonography showed no gestational sac.
Accordingly, the patient was diagnosed with ectopic pregnancy in the cesarean scar
site and, therefore, weekly usage of methotrexate was prescribed for her. Since she
did not respond to the treatment, she was referred to our department in the Faculty
of Medicine. The evaluation showed mass invasion through the entire uterine wall.
The uterus preservation was not possible, therefore, total hysterectomy was
performed. The pathology report confirmed CC in the cesarean scar.
Conclusion: Based on previous studies, as the number of cesarean sections
increases, the possibility of complications rises, as well. Cesarean scars implantation
of CC is one of the rare complications of caesarean section. The probability of a
gestational trophoblastic disease should be considered in any woman during her
pregnancy. Early detection and proper management of the complications can result
in a decrease in morbidity and mortality.
