Metastatic choriocarcinoma with spontaneous splenic rupture following term pregnancy: A case report

Choriocarcinoma is a rare neoplasm which often spreads extensively. The metastases sometimes appear in the abdominal cavity where they can cause dramatic symptoms. We here describe a patient who had received a cesarean section twelve days before and intraperitoneal hemorrhage was diagnosed when she visited Chang Gung Memorial Hospital's emergency department. At laparotomy, ruptured spleen with active bleeding was found and splenectomy was performed. The histopathologic study revealed a metastatic choriocarcinoma. Multiagent chemotherapy was administered and the patient responded well. To our knowledge, this is the fourth reported case that metastatic choriocarcinoma resulted in spleen rupture presenting as the principal sign of acute hemoperitoneum. Metastatic choriocarcinoma with rupture should be considered a cause of intraperitoneal hemorrhage in women of child-bearing age.