Uterine choriocarcinoma with negative specific serum radioimmunoassay for human chorionic gonadotropins

A case of uterine choriocarcinoma complicating gestational trophoblastic disease is presented. Following chemotherapy, there seemed to be an apparent cure as indicated by follow-up monitoring of the beta subunit of human chorionic gonadotropin (B-HCG assay) when the assay demonstrated three consecutive weekly negative results. At the same period when the assays were negative, the patient was manifesting irregular vaginal bleeding for which diagnostic D&C was done revealing persistant disease which was not detected by measurement with the sensitive quantitiative B-HCG assay. The case is discussed to confirm the fact that clinical assessment is necessary for the follow-up of trophoblastic disease in addition to quantitative B-HCG.