Non-gestational choriocarcinoma (NGCO) of the ovary is rare, with a prevalence of less than 0.6% of all ovarian germ-cell tumors; and when found with other germ cell tumors, pure NGCO is exceedingly rare. We herein report the case of a 22-year-old woman who complained of menstrual disorders for over 2 months. MRI examination revealed an 11.4 cm right adnexal mass of the uterus, and the patients manifested an elevated serum level of β-hCG of 77,928 mIU/ml. Fertility-preserving surgery was performed, and the pathologic diagnosis was pure NGCO; immunohistochemical staining showed cancer cells that were positive for β-hCG, CK, hPL, SALL4, and Ki-67 (>80% of cells stained). We performed polymorphic DNA analysis and non-gestational origin was confirmed. The patient was then treated with six courses of chemotherapy with a BEP regimen, after which her serum β-hCG levels declined to normal levels, and she was free of disease at the 30-month follow-up.

1. Jia, N, Chen, Y, Tao, X, et al. A gestational choriocarcinoma of the ovary diagnosed by DNA polymorphic analysis: a case report and systematic review of the literature. J Ovarian Res 2017; 10: 46.
Google Scholar | Crossref | Medline2. Haruma, T, Ogawa, C, Nishida, T, et al. Pure choriocarcinoma of the ovary in Silver-Russell syndrome. Acta Med Okayama 2015; 69: 183–188.
Google Scholar | Medline3. Lv, L, Yang, K, Wu, H, et al. Pure choriocarcinoma of the ovary: a case report. J Gynecol Oncol 2011; 22: 135–139.
Google Scholar | Crossref | Medline | ISI4. Hayashi, S, Abe, Y, Tomita, S, et al. Primary non-gestational pure choriocarcinoma arising in the ovary: a case report and literature review. Oncol Lett 2015; 9: 2109–2111.
Google Scholar | Crossref | Medline5. Kong, B, Tian, YJ, Zhu, WW, et al. A pure nongestational ovarian choriocarcinoma in a 10-year-old girl: case report and literature review. J Obstet Gynaecol Res 2009; 35: 574–578.
Google Scholar | Crossref | Medline6. Yamamoto, E, Ino, K, Yamamoto, T, et al. A pure nongestational choriocarcinoma of the ovary diagnosed with short tandem repeat analysis: case report and review of the literature. Int J Gynecol Cancer 2007; 17: 254–258.
Google Scholar | Crossref | Medline | ISI7. Fisher, RA, Newlands, ES, Jeffreys, AJ, et al. Gestational and nongestational trophoblastic tumors distinguished by DNA analysis. Cancer 1992; 69: 839–845.
Google Scholar | Crossref | Medline | ISI8. Rao, KV, Konar, S, Gangadharan, J, et al. A pure non-gestational ovarian choriocarcinoma with delayed solitary brain metastases: case report and review of the literature. J Neurosci Rural Pract 2015; 6: 578–581.
Google Scholar | Crossref | Medline9. Hirabayashi, K, Yasuda, M, Osamura, RY, et al. Ovarian nongestational choriocarcinoma mixed with various epithelial malignancies in association with endometriosis. Gynecol Oncol 2006; 102: 111–117.
Google Scholar | Crossref | Medline10. Koyanagi, T, Fujiwara, H, Usui, H, et al. Ovarian nongestational choriocarcinoma and associated adenocarcinoma with the same germ cell origin determined by a molecular genetic approach: a case report. Pathol Int 2016; 66: 529–534.
Google Scholar | Crossref | Medline11. Jiao, LZ, Xiang, Y, Feng, FZ, et al. Clinical analysis of 21 cases of nongestational ovarian choriocarcinoma. Int J Gynecol Cancer 2010; 20: 299–302.
Google Scholar | Crossref | Medline12. Wang, Q, Guo, C, Zou, L, et al. Clinicopathological analysis of non-gestational ovarian choriocarcinoma: report of two cases and review of the literature. Oncol Lett 2016; 11: 2599–2604.
Google Scholar | Crossref | Medline13. Goswami, D, Sharma, K, Zutshi, V, et al. Nongestational pure ovarian choriocarcinoma with contralateral teratoma. Gynecol Oncol 2001; 80: 262–266.
Google Scholar | Crossref | Medline14. Heo, EJ, Choi, CH, Park, JM, et al. Primary ovarian choriocarcinoma mimicking ectopic pregnancy. Obstet Gynecol Sci 2014; 57: 330–333.
Google Scholar | Crossref | Medline15. Saito, M, Azuma, T, Nakamura, K. On ectopic choriocarcinoma. World Obstet Gynecol 1963; 17: 459–484.
Google Scholar