A 71-year-old man was referred to our hospital complaining of gross hematuria. Cystoscopy revealed a wide based papillary bladder tumor. We perfomed transurethral resection of the bladder tumor followed by total cystectomy and ureterocutaneostomy. Pathologically, the tumor was found to be a pT3b pN0 choriocarcinoma. Immunohistochemical staining showed human chorionic gonadotropin (HCG)-positive tumor cells. One month after surgery, serum HCG level was elevated, and computed tomography revealed multiple lung, liver, and lymph node metastases. Four cycles of salvage chemotherapy with bleomycin, etoposide, plus cisplatin (BEP) were administered. The metastatic lesions showed partial response, and the serum HCG level fell to within the normal range. Soon afterwards, however, serum HCG was again elevated, and four cycles of chemotherapy with gemcitabine plus cisplatin (GC) were administered followed by one cycle of chemotherapy with gemcitabine plus paclitaxel (GP). However, there was no response and the patient died 17 months after surgery.
