Abstract
Metastatic choriocarcinoma of the tonsil is very rare. A case of such a metastatic tumor arising 17 months after induced abortion is reported here.
A 34-year-old female visited our hospital with the complaint of continuous bleeding from the oral cavity. A 5×5mm hemonecrotic tumor was found in the upper pole of her left tonsil. The tonsil was completely removed including this tumor, and bleeding ceased.
The histopathological examination of the tumor revealed metastatic choriocarcinoma, so a pregnancy test was performed. It showed markedly elevated human chorionic gonadotropin (HCG) in the urine. The chest radiogram disclosed two abnormal shadows in the left lung field.
A total hysterectomy with right oophorectomy and wedge resection of the left ovary was performed combined with pre- and post-operative chemotherapy. Then left lower lobectomy was carried out.
The lung specimen showed metastatic choriocarcinoma with marked necrosis, although no evidence of tumor was found in the uterus or ovaries.
Follow-up studies for 1 year revealed no signs of local recurrence or distant metastasis, and HCG in the urine remained within normal limits.
A possible mechanism of the metastatic process is discussed with special reference to the characteristics of metastatic choriocarcinoma to the tonsil.
