{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:39:49Z","timestamp":1787243989362,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,25]],"date-time":"2022-12-25T00:00:00Z","timestamp":1671926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Science Foundation of Hubei Province, China","award":["2021CFB361"],"award-info":[{"award-number":["2021CFB361"]}]},{"name":"Natural Science Foundation of Hubei Province, China","award":["2021EHB025"],"award-info":[{"award-number":["2021EHB025"]}]},{"name":"International Scientific and Technological Cooperation Project of Hubei Province, China","award":["2021CFB361"],"award-info":[{"award-number":["2021CFB361"]}]},{"name":"International Scientific and Technological Cooperation Project of Hubei Province, China","award":["2021EHB025"],"award-info":[{"award-number":["2021EHB025"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Choriocarcinoma is a highly malignant trophoblastic tumor that occurs mostly in women of childbearing age. The main mode of metastasis is hematogenous metastasis. The most common sites of metastasis are the lung, vagina and brain, while splenic metastasis is rare. Because of its rapid development, extensive metastasis can occur in a short period, and some patients only show metastatic symptoms, which are often missed or misdiagnosed as ectopic pregnancy or other diseases. We describe a rare case of splenic metastatic choriocarcinoma with acute abdominal pain caused by nontraumatic splenic rupture. In addition, we review the previous literature on splenic metastasis of choriocarcinoma and summarize the clinical manifestations, management measures and prognoses. Our case and literature review indicate that splenic metastatic choriocarcinoma is rare and difficult to distinguish from splenic ectopic pregnancy and other diseases. Clinicians should strengthen their understanding of this disease and avoid misdiagnosis.<\/jats:p>","DOI":"10.3390\/jcm12010157","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T02:55:07Z","timestamp":1672109707000},"page":"157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Splenic Metastatic Choriocarcinoma with Nontraumatic Splenic Rupture: A Case Report and Literature Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3128-3117","authenticated-orcid":false,"given":"Yifan","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Xiaogan Hospital, Wuhan University of Science and Technology, Xiaogan 432000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengguang","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.gore.2017.03.014","article-title":"Choriocarcinoma with brain, lung and vaginal metastases successfully treated without brain radiation or intrathecal chemotherapy: A case report","volume":"20","author":"Frost","year":"2017","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/S0140-6736(10)60280-2","article-title":"Gestational trophoblastic disease","volume":"376","author":"Seckl","year":"2010","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/AOG.0000000000004240","article-title":"Gestational Trophoblastic Disease: Current Evaluation and Management","volume":"137","author":"Soper","year":"2021","journal-title":"Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0020-7292(03)90120-2","article-title":"Gestational trophoblastic neoplasia, FIGO 2000 staging and classification","volume":"83","author":"Ngan","year":"2003","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3000605211033222","DOI":"10.1177\/03000605211033222","article-title":"Ultra-high-risk choriocarcinoma with atraumatic splenic rupture: A rare case report","volume":"49","author":"Zhang","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/ijgo.13877","article-title":"Diagnosis and management of gestational trophoblastic disease: 2021 update","volume":"155","author":"Ngan","year":"2021","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.ajog.2010.06.073","article-title":"Gestational trophoblastic disease I: Epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole","volume":"203","author":"Lurain","year":"2010","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tjog.2015.05.011","article-title":"Unusual clinical presentations of choriocarcinoma: A systematic review of case reports","volume":"56","author":"Mangla","year":"2017","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"526","DOI":"10.5858\/2000-124-0526-MTTTS","article-title":"Metastatic tumors to the spleen: A 25-year clinicopathologic study","volume":"124","author":"Lam","year":"2000","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_10","first-page":"381","article-title":"Acute intestinal obstruction and splenic hemorrhage due to metastatic choriocarcinoma. A case report","volume":"151","author":"Kristoffersson","year":"1985","journal-title":"Acta Chir. Scand."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.5833\/jjgs.42.1637","article-title":"A Case of Choriocarcinoma with Spontaneous Bleeding for Splenic Rupture","volume":"42","author":"Irei","year":"2009","journal-title":"Jpn. J. Gastroenterol. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/j.1447-0756.1996.tb00996.x","article-title":"Choriocarcinoma complicated by splenic rupture: An unusual presentation","volume":"22","author":"Challis","year":"1996","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"W12","DOI":"10.1308\/147870808X257229","article-title":"Choriocarcinoma of the spleen--a rare cause of atraumatic rupture","volume":"90","author":"Ghinescu","year":"2008","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.14740\/wjon1356","article-title":"An Extremely Rare Case of Splenic Rupture Secondary to Metastatic Gestational Choriocarcinoma","volume":"12","author":"Luu","year":"2021","journal-title":"World J. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"7518","DOI":"10.1186\/1757-1626-2-7518","article-title":"Gestational choriocarcinoma diagnosed with spontaneous splenic rupture after pregnancy induced by in vitro fertilization: A case report","volume":"2","author":"Yuruyen","year":"2009","journal-title":"Cases J."},{"key":"ref_16","first-page":"1002","article-title":"Gestational Choriocarcinoma of the Uterus with Concurrent Metastasis and an Atraumatic Rupture of the Spleen: A Rare Association and First Description in Africa","volume":"1","author":"Mukuku","year":"2019","journal-title":"Am. J. Obstetr. Gynecol. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"79","DOI":"10.14701\/ahbps.2018.22.1.79","article-title":"Laparoscopic splenectomy for splenic rupture secondary to metastatic choriocarcinoma","volume":"22","author":"Aloysius","year":"2018","journal-title":"Ann. Hepatobiliary Pancreat. Surg."},{"key":"ref_18","first-page":"166","article-title":"Metastatic choriocarcinoma with spontaneous splenic rupture following term pregnancy: A case report","volume":"19","author":"Hou","year":"1996","journal-title":"Changgeng Yi Xue Za Zhi"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1089\/gyn.2011.0052","article-title":"Ovarian Choriocarcinoma with Concurrent Metastases to the Spleen and Adrenal Glands: First Case Report","volume":"28","author":"Ramarajapalli","year":"2012","journal-title":"J. Gynecol. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10397-010-0630-z","article-title":"Splenic rupture: A rare presentation of metastatic choriocarcinoma","volume":"8","author":"Nethra","year":"2010","journal-title":"Gynecol. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.15761\/COGRM.1000105","article-title":"Successful embolisation of a life threatening bleeding splenic metastasis in a patient with gestational choriocarcinoma","volume":"1","author":"Galazi","year":"2015","journal-title":"Clin. Obstet. Gynecol. Reprod. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1023\/B:NEON.0000013499.74404.81","article-title":"Prognostic factors and therapeutic problems of primary intracranial choriocarcinoma\/germ-cell tumors with high levels of HCG","volume":"66","author":"Shinoda","year":"2004","journal-title":"J. Neurooncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ajog.2010.06.072","article-title":"Gestational trophoblastic disease II: Classification and management of gestational trophoblastic neoplasia","volume":"204","author":"Lurain","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/IGC.0000000000000070","article-title":"Analysis of the prognosis and related factors for patients with stage IV gestational trophoblastic neoplasia","volume":"24","author":"Yang","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"277","DOI":"10.5468\/ogs.2015.58.4.277","article-title":"Role of surgical therapy in the management of gestational trophoblastic neoplasia","volume":"58","author":"Eoh","year":"2015","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S130","DOI":"10.1016\/S0020-7292(12)60026-5","article-title":"Trophoblastic disease","volume":"119","author":"Ngan","year":"2012","journal-title":"Int. J. Gynaecol. Obstet."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/157\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:50:42Z","timestamp":1760147442000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,25]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010157"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010157","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,25]]}}}