{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:02:15Z","timestamp":1777726935795,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Choriocarcinoma is a malignant tumor associated with early vascular invasion and a high mortality. Ultra-high-risk choriocarcinoma, which was proposed in the International Federation of Gynecology and Obstetrics cancer report of 2018, has a higher risk of treatment failure and a worse prognosis than choriocarcinoma. We report a rare case of a 39-year-old female patient with ultra-high-risk choriocarcinoma (stage IV:20) with hemorrhage secondary to atraumatic splenic rupture as the initial sign. A satisfactory outcome was achieved through comprehensive treatment with surgery, chemotherapy, immunotherapy, and targeted therapy.<\/jats:p>","DOI":"10.1177\/03000605211033222","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T02:31:57Z","timestamp":1627957917000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultra-high-risk choriocarcinoma with atraumatic splenic rupture: a rare case report"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8717-8420","authenticated-orcid":false,"given":"Jun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynecology, Tianjin Third Central Hospital, The Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, 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