A Case of Choriocarcinoma with Spontaneous Bleeding for Splenic Rupture

Satoko Irei, Hiroshi Miyazato, Yoshiki Chinen, Ken Hayasaka, Ryou Murabayashi, Toru Takaesu, Izumi Kinjou, Hirofumi Tomori and Kazuya Yamashiro

Department of Surgery, Naha City Hospital

We report a case of spontaneous splenic rupture secondary to metastatic choriocarcinoma. A 34-year old woman confirmed with a positive pregnancy test and referred for sudden severe abdominal pain. Initially, it was diagnosed with intraabdominal hemorrhage due to ruptured ectopic pregnancy. Physical examination on admission showed shock with severe abdominal distension. Abdominal computed tomography (CT) showed massive free fluid collection in the upper and lower abdominal cavity. Chest CT showed multiple nodules in both lung fields, suspected to be malignant tumor metastasis and necessitating surgery. That comfirmed spontaneous splenic rupture due to metastatic choriocarcinoma, pathologically confirmed to be metastatic choriocarcinoma. Her postoperative splenectomy course was uneventful. Although this condition is rare, it should be borne in mind that spontaneous splenic rupture is an important differential diagnosis in patients with hemorrhagic acute abdomen.

Key words
splenic rupture, choriocarcinoma

Reprint requests
Satoko Irei Department of Surgery, Naha City Hospital
2-31-1 Furujima, Naha, 902-8511 JAPAN

Accepted
February 18, 2009

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