AN EXCEPTIONAL CASE OF CERVICAL CHORIOCARCINOMA HIGHLIGHTING THE RARITY BEYOND THE UTERINE BODY: CASE REPORT AND REVIEW OF LITERATURE

Choriocarcinoma is an aggressive trophoblastic tumor[1], the uterine cavity being its most frequent site of development.[2] Extra-uterine choriocarcinomas are extremely rare and represent a small proportion of gestational choriocarcinomas.[1] Among these rare localizations, the cervix is considered the most commonly reported site, although its overall incidence remains exceptionally low.[2] In the present case, a 29-year-old multiparous patient, was admitted to the maternal emergency department with mild pelvic pain and vaginal bleeding. Cervical pregnancy was the most likely diagnosis (considering that the patient had six weeks of amenorrhea and elevated serum β-hCG levels). We carried out a surgical exploration by laparotomy (laparoscopy was not available), and performed a resection of the entire mass, which included placental debris. Pathological examination returned results in favor of poorly differentiated tumor proliferation, suggesting a primary cervical choriocarcinoma. This case underscores the diagnostic challenges associated with cervical choriocarcinoma. The rarity of this entity, combined with its atypical presentation, contributes to delayed diagnosis and potential mismanagement. Early diagnosis of this rare entity is essential in order to avoid delays in treatment and improve prognosis. Clinicians must maintain heightened awareness of this rare but life-threatening condition when evaluating patients with suspected cervical pregnancy or unexplained gynecological bleeding associated with positive pregnancy markers.