Choriocarcinoma is a malignant neoplasm arising from the trophoblast. While it is most commonly associated with molar pregnancies, it can also occur following a normal pregnancy, albeit less frequently. Postpartum choriocarcinoma is a rare entity often diagnosed late due to its nonspecific symptoms, which can mimic other common postpartum bleeding causes such as retained products of conception or postpartum endometritis.

Due to the challenges in early detection and variable chemosensitivity, the prognosis for postpartum choriocarcinoma is often poor, leading to the need for radical surgery, such as total hysterectomy, to remove the primary tumor.

We report a rare case of a 35-year-old woman who presented to our hospital approximately two months postpartum with persistent vaginal bleeding. Serum beta-hCG levels were elevated at 48,062 mIU/ml. Pelvic ultrasound revealed a heterogeneous, hypervascular mass measuring 45x 51x 28 mm within the uterine cavity with 0.5 cm myometrial invasion. Chest X-ray and CT scan showed multiple pulmonary nodules bilaterally. Abdominal ultrasound and brain CT were unremarkable. The patient was diagnosed with postpartum choriocarcinoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy (FIGO: 8 point). Postoperatively, she received multi-agent chemotherapy (EMA-CO) and radiofrequency ablation of the pulmonary nodules. After 3 months of treatment, serum beta-hCG levels normalized and have remained undetectable for over a year with no recurrence of disease.