Diagnostic mimicry and management of rare pure form of ovarian cancer

A new case report was published in Volume 12 of Oncoscience on July 28, 2025, titled "A rare case of pure non-gestational ovarian choriocarcinoma: Diagnostic mimicry and management strategies."

This report, led by Naina Kumar from the All India Institute of Medical Sciences, Bibinagar, details the case of a 36-year-old woman diagnosed with a rare pure form of ovarian cancer called non-gestational ovarian choriocarcinoma (NGOC). This is an extremely rare tumor, affecting less than 0.6% of malignant ovarian germ cell tumors. It usually appears in young women and is difficult to diagnose because it shares symptoms with pregnancy-related conditions, such as vaginal bleeding and high levels of the pregnancy hormone β-hCG. 

"Non-gestational ovarian choriocarcinomas (NGOC) are rare, distinct, highly aggressive tumors, primarily affecting young women."

In this case, the patient had been experiencing abnormal bleeding for several months. A positive pregnancy test and imaging studies led doctors to initially suspect an ectopic pregnancy. Advanced imaging and blood tests revealed a large mass in the right ovary. Surgery was performed to remove it along with the uterus, ovaries, and nearby lymph nodes. Genetic testing of the tumor tissue showed that it contained only maternal DNA, confirming it as non-gestational. This confirmation is important because non-gestational tumors are more aggressive and respond differently to treatment compared to tumors linked to pregnancy.

The patient received a chemotherapy regimen that included Bleomycin, Etoposide, and Cisplatin. After two cycles, her β-hCG levels returned to normal, indicating a complete response to treatment. She remains under regular follow-up with hormone monitoring and imaging scans to evaluate for any recurrence.

This case highlights the challenge of diagnosing pure NGOC, especially when the symptoms closely resemble more common conditions. It also shows how genetic testing and imaging can help guide accurate diagnosis and appropriate treatment. Early detection and timely intervention can lead to favorable outcomes, even in aggressive cancers like NGOC.

As one of the few documented cases of pure NGOC, this report adds valuable knowledge to the limited literature on this rare tumor type. It emphasizes the need for clinicians to consider rare diagnoses when common conditions do not fully explain a patient's symptoms.