A rare case of primary extragenital choriocarcinoma in the spleen presenting as acute abdominal pain

Abstract

Abstract Objectives This study reports a rare case of primary extragenital choriocarcinoma in the spleen presenting as acute abdominal pain. We expect this case to provide more valuable information for clinicians in the future. Case presentation The patient was a 22-year-old woman, with a healthy child and a history of bilateral ovarian cyst resection a week before, who presented with severe and sudden pain in the left upper abdomen. The patient was admitted to the emergency department. Emergency ultrasound revealed a huge solid mass in the enlarged spleen. Emergency computed tomography examination suggested acute splenic rupture. Microscopic examination confirmed that the mass contained nested syncytiotrophoblast and cytotrophoblast cells, and the serum beta-human chorionic gonadotropin (β-hCG) level was 54,547.6 IU/L (normal β-hCG level <5 IU/L) after surgery. Primary extragenital choriocarcinoma in the spleen was considered as the cause of splenic rupture. Conclusions Primary extragenital choriocarcinoma of the spleen is extremely rare. Serum β-hCG tests and systemic abdominal ultrasonography are of great value for the diagnosis of the disease.