Metastatic Choriocarcinoma Masquerading as a Congenital Glabellar Hemangioma

Pediatr Dev Pathol. 2019 Jan-Feb;22(1):59-64. doi: 10.1177/1093526618765039. Epub 2018 Mar 16.


Infantile choriocarcinoma (ICC) is a rare, highly malignant form of gestational trophoblastic neoplasia. Rapid diagnosis and initiation of treatment are paramount in reaching a successful outcome. Patients with these tumors typically present with a triad of anemia, hepatomegaly, and precocious puberty. Cutaneous manifestations of ICC are extraordinarily rare with few documented cases. Here, we describe a male neonate who presented to our Dermatology clinic with a rapidly growing, markedly vascular glabellar mass associated with abnormal laboratory values suggestive of Kasabach-Merritt phenomenon. The initial clinical impression of infantile hemangioma led to an initial treatment with propranolol. However, the mass continued to enlarge and a biopsy was obtained. Histology revealed a high-grade, poorly differentiated carcinoma. A robust immunohistochemical battery demonstrated tumor reactivity with Glut-1, GATA3, Glypican-3, CAM5.2, and β-hCG establishing the diagnosis of metastatic choriocarcinoma. The diagnosis was further supported by the elevated serum β-hCG. In addition to the glabellar mass, imaging demonstrated tumor foci in the liver and lung. Clinical investigation of the mother revealed no evidence of disease.

Keywords: clinical neonatology; dermatopathology; immunohistochemistry; liver; pediatric; placenta; soft tissue tumors; surgical pathology.

Publication types

  • Case Reports

MeSH terms

  • Choriocarcinoma / congenital
  • Choriocarcinoma / diagnosis
  • Choriocarcinoma / pathology
  • Choriocarcinoma / secondary*
  • Diagnosis, Differential
  • Fatal Outcome
  • Hemangioma / congenital
  • Hemangioma / diagnosis*
  • Hemangioma / pathology
  • Humans
  • Infant
  • Liver Neoplasms / congenital
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary*
  • Lung Neoplasms / congenital
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Male
  • Skin Neoplasms / congenital
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary*