A 15-year-old girl presents with left lower abdominal pain. She has noted recent enlargement of her breasts. Her last menstrual period was 10 weeks ago. She denies having had sexual intercourse. Serum levels of hCG are markedly elevated. Which of the following is the most likely diagnosis?
Choriocarcinoma of the ovary is a rare tumor that mimics the epithelial covering of placental villi (cytotrophoblast and syncytiotrophoblast). Choriocarcinoma of germ cell origin manifests in young girls as precocious sexual development, menstrual irregularities, and rapid breast enlargement. In women of reproductive age, ovarian choriocarcinoma may represent metastasis from an intrauterine gestational tumor. Microscopically, it displays an admixture of malignant cytotrophoblast and syncytiotrophoblast. The syncytial cells of choriocarcinoma secrete hCG, which accounts for the frequent finding of a positive pregnancy test result. The tumor is highly aggressive but responds to chemotherapy. Hydatidiform mole secretes hCG but is a gestational trophoblastic disease. The other choices do not secrete hCG.Diagnosis: Choriocarcinoma of the ovary
Choriocarcinoma
Hydatidiform mole
Mature cystic teratoma
Serous cystadenocarcinoma
Female Genital Tract