Markedly elevated maternal serum alpha-fetoprotein associated with a normal fetus and choriocarcinoma of the placenta

David A. Ollendorff*, Jeffrey M. Goldberg, Graziella M. Abu-Jawdeh, John R. Lurain

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Determination of maternal serum alpha-fetoprotein (MSAFP) has become an important screening test for a variety of fetal and maternal abnormalities. A 33-year-old multiparous white woman had a markedly elevated MSAFP level (140 multiples of the median). Extensive antepartum work-up for fetal anomalies, fetal-maternal transfusion, or maternal etiology revealed no explanation. The patient subsequently delivered a healthy male infant. Pathologic examination of the placenta demonstrated a small, discrete area of choriocarcinoma. Computed tomography showed a solitary pulmonary metastasis. Because the patient did not desire future pregnancies, a total abdominal hysterectomy was performed, followed by four courses of EMA-CO chemotherapy. Her serum hCG levels subsequently became undetectable. Choriocarcinoma of the placenta must be considered in the differential diagnosis of an otherwise unexplained elevated MSAFP level.

Original languageEnglish (US)
Pages (from-to)494-497
Number of pages4
JournalObstetrics and gynecology
Volume76
Issue number3
StatePublished - Sep 1990

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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