Abstract

Gestational choriocarcinoma is a highly malignant form of gestational trophoblastic neoplasia often seen with local and distant metastasis. It can arise from any type of pregnancy and presents with varied clinical signs and symptoms. Here, we present gestational choriocarcinoma cases diagnosed at Jigme Dorji Wangchuck National Referral Hospital with a variety of clinical presentation and the treatment outcomes. Six cases were confirmed in 2 years. Two cases presented with lung metastases; one with hemoptysis and the other with a chronic cough and lung mass. Three had large pelvic masses and abnormal vaginal bleeding. One patient had persistent uterine bleeding after a miscarriage. Two of the six patients had failed to follow-up after the diagnosis of molar pregnancy. Multiagent chemotherapy with selective hysterectomy and beta-hCG surveillance led to favorable outcomes. Teaching points: • A high degree of clinical suspicion is necessary for early diagnosis and appropriate treatment • Strict adherence to follow-up after molar pregnancy is important to avoid complications

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