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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Gynecological Oncology

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1600200

This article is part of the Research TopicPhysiology and Pathophysiology of PlacentaView all 9 articles

Intraplacental choriocarcinoma and Spontaneous fetomaternal hemorrhage: cross clues and bring a case to book

Provisionally accepted
Li  WangLi Wang1,2Xuri  LiXuri Li3Dongfang  BaiDongfang Bai4Ran  DuRan Du5Linna  LuLinna Lu5Yujie  LiYujie Li4Xiuyu  WangXiuyu Wang5*
  • 1Department of Gynecology & Obstetrics, Liaocheng People’s Hospital, School of Medicine, Liaocheng University, Liaocheng, China, Liaocheng, China
  • 2Department of Gynecology Oncology, Shandong Provincial Key Medical and Health Laboratoy of Liaocheng Infectious Disease Hospital, Liaocheng, China
  • 3Department of Gynecology & Obstetrics Qingdao Hospital of Traditional Chinese Medicine, Qingdao, China
  • 4School of Medicine, Liaocheng University, Liaocheng, Shandong Province, China
  • 5Department of Pathology, Liaocheng People's Hospital, Liaocheng, Shandong Province, China

The final, formatted version of the article will be published soon.

Background: Intraplacental choriocarcinoma (IC) is an extremely rare malignancy of the placenta, often associated with fetomaternal hemorrhage (FMH). This combination is challenging to diagnose antepartum and is associated with high perinatal mortality, predominantly due to severe fetal anemia.Methods: We report a case of IC associated with FMH and conducted a systematic review of cases published in the English and Chinese literature. Data from these cases were combined to evaluate clinical characteristics, diagnostic approaches, treatment options and outcomes.Results: A 31-year-old woman presented with decreased fetal movements at 34+2 weeks of gestation. Following an emergent cesarean section, the infant was found to be severely anemic and passed away shortly after delivery. Placental histopathology revealed IC. The patient received chemotherapy with EMA/CO and showed no evidence of metastasis or recurrence over 12 months of follow-up. The systematic review identified 35 cases of IC associated with FMH. Common diagnostic clues included decreased fetal movements, abnormal middle cerebral artery Doppler studies, and FMH. Despite the severe perinatal outcomes, maternal prognosis was generally favorable with chemotherapy in cases of metastasis. Conclusion: IC with FMH is a rare but life-threatening condition requiring high clinical suspicion and prompt placental histopathology for diagnosis. Early recognition of fetal anemia and FMH is essential for timely intervention.

Keywords: Intraplacental choriocarcinoma, Fetomaternal hemorrhage, Pathology, Clinical Characteristics, outcomes

Received: 26 Mar 2025; Accepted: 31 Jul 2025.

Copyright: © 2025 Wang, Li, Bai, Du, Lu, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xiuyu Wang, Department of Pathology, Liaocheng People's Hospital, Liaocheng, 252000, Shandong Province, China

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