Gestational trophoblastic disease discovered at the stage of choriocarcinoma extending to the cervix

A 53-year-old perimenopausal woman presented with postcoital bleeding. Clinical examination revealed the patient to be in good general condition with a pale conjunctiva. Gynecological examination, using a speculum, revealed cervical bleeding related to a friable mass on the upper lip of the cervix that bled upon contact. Suspecting cervical cancer, a cervical biopsy was performed, and the histopathological examination confirmed choriocarcinoma. Consequently, a quantitative beta-hCG test was ordered, which was elevated at 480,000 mIU/mL, and a pelvic magnetic resonance imaging (MRI) was performed, which showed a 5 cm heterogeneous cervical tumor without locoregional extension. Following a multidisciplinary consultation, the decision was made to complete the workup with further staging and to discuss chemotherapy. Before the thoraco-abdomino-pelvic computed tomography (CT) scan, the patient presented to our emergency department in a state of hemorrhagic shock with heavy vaginal bleeding. Laboratory tests revealed a hemoglobin level of 3 g/dL. Given the life-threatening situation, an emergency hysterectomy was performed, resulting in a good clinical and laboratory outcome.