Pure non-gestational ovarian choriocarcinoma in a postmenopausal woman coexisting with a clear cell adenofibroma and endometriosis foci: A case report and review of the literature.

Ovarian germ cell tumours are uncommon, with choriocarcinoma being the rarest of them. Among choriocarcinomas, the non-gestational type occurs mainly in premenarchal women, although cases have been described in postmenopausal women. The distinction between gestational or non-gestational aetiology of choriocarcinoma is essential given the prognostic and therapeutic implications involved. The distinction between pure and mixed form of choriocarcinoma also has prognostic relevance. Clear cell adenofibroma is a rare benign lesion, considered a precursor of clear cell carcinoma, with described association to endometriosis. We present the case of a 72-year-old woman diagnosed at our centre with pure non-gestational choriocarcinoma, clear cell adenofibroma and foci of endometriosis present in the same ovary. We performed a review of the literature, focusing on how to differentiate a gestational from a non-gestational choriocarcinoma and the pure form from the mixed form, as well as the described coexistence between germ cell and epithelial tumours.