Molecular clues to the rescue: differentiating gestational and non-gestational ovarian choriocarcinoma—a case report

Non-gestational ovarian choriocarcinoma (NGOC) is a rare and aggressive tumor. Distinguishing NGOC from its gestational counterpart especially in the reproductive age group often presents as a diagnostic challenge. The treatment and prognoses of both differ significantly. Molecular methods are gold standard and should be used in establishing an accurate diagnosis is such cases. A sexually active 22-year-old Indian female presented with irregular menstrual cycles and abdominal pain. Imaging revealed a right ovarian mass with liver and lung metastases. She underwent surgical resection of the ovarian tumor. Histopathology suggested choriocarcinoma, and molecular analysis using a PCR-based assay confirmed the absence of Y chromosome DNA, establishing the diagnosis of NGOC. She received BEP chemotherapy and showed a complete metabolic response and is currently on follow-up. This case highlights the critical role of molecular diagnostics in differentiating NGOC from GOC. It also emphasizes the importance of early diagnosis and timely initiation of appropriate chemotherapy in achieving favorable outcomes in this rare but potentially curable malignancy.