A rare case of fallopian tubal choriocarcinoma rupture coexistent with intrauterine pregnancy

Choriocarcinoma coexisting with intrauterine pregnancy is extremely rare and necessitates early diagnosis. A primigravida at 27+ weeks of gestation presented with a 3-day history of worsening abdominal pain. An ultrasound revealed a uterine mass, initially misdiagnosed as a degenerated uterine myoma. The correct diagnosis of a ruptured and bleeding fallopian tube choriocarcinoma was only made after a laparotomy which was prompted by patient’s significant abdominal hemorrhage and fetal death. Acute abdomen and intra-abdominal hemorrhage during pregnancy should raise suspicion of choriocarcinoma.