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Unusual presentation of a metastatic choriocarcinoma following a full term pregnancy: a case report.

Choriocarcinoma most commonly follows a molar pregnancy, but it may develop after any gestational event. If choriocarcinoma follows a term pregnancy, it is associated with an unfavorable outcome and a 60% survival rate. A 33 year female who had delivered a normal girl 4 months before, presented with a nodule on the scalp behind the right ear. The pathologic diagnosis was compatible with metastatic choriocarcinoma. This tumor did not respond to chemotherapy, and she died a year later of multiple liver and pulmonary metastases. The development of a choriocarcinoma following a full term pregnancy is associated with a poor prognosis. We suggest that patients who do not achieve a clinical or serological remission after EMA-CO treatment be considered for high dose chemotherapy such as transplant.