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Obstet Gynecol. 1990 Mar;75(3 Pt 2):547-9.

Ovarian choriocarcinoma: a difficult diagnosis of an unusual tumor and a review of the hook effect.

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  • 1Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, Louisiana.


Ovarian choriocarcinoma is difficult to diagnose in the reproductive-age patient. A case of nongestational ovarian choriocarcinoma is discussed which presented like a molar pregnancy initially. Because of falsely low beta-hCG values (283 mIU/L) caused by the high-dose "hook effect" in the double antibody immunoassay system, however, a diagnosis of ectopic pregnancy was entertained. At laparotomy, a large necrotic ovarian choriocarcinoma was found along with large theca lutein cysts. The hook effect may mislead the clinician, and it is important to recognize this effect to avoid misdiagnosis.

[PubMed - indexed for MEDLINE]
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