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A CASE REPORT OF SUCCESSFUL MANAGEMENT OF GESTATIONAL CHORIOCARCINOMA WITH SUBURETHRAL METASTASIS AND LUNG METASTASIS Presented by- Dr Neha yadav, resident obstetrics and gynaecology at Pacific institute of medical sciences, udaipur INTRODUCTION -Gestational choriocarcinoma is a highly malignant form of gestational trophoblastic neoplasia often seen with local and distant metastasis. It can arise from any type of pregnancy. CASE-A 30 yr old female G2P1L1 with 2 months Amenhorrhea presented with 5 days history of Vaginal Bleeding P/V along with urinary incontinence and Abdominal Pain associated with Nausea and vomiting was seen since 8 days. P/A abdomen was soft and non tender. On P/V examination bleeding present with sub urethral bluish nodule.usg showed Snow storm appearance.Serum B-HCG ? 1,95,000mIU/mL. MRI ? PELVIS suggestive of Invasive Molar Pregnancy with metastasis.choriocarcinoma diagnosed.Chemotherapy (EMACO regime) is given & follow up beta-hCG levels and other investigation. DISCUSSION-Gestational choriocarcinoma is a highly malignant and aggressive trophoblastic tumor. About 50% of GTN arise from hydatidiform mole.The common gynecological presentations are abnormal vaginal bleeding and pelvic mass.Gestational trophoblastic neoplasia (GTN) including choriocarcinoma is highly sensitive to chemotherapy.Patients with high-risk diseases are generally given multi-agent EMACO regimen, and cure rate approaches 80?90% CONCLUSION A variety of clinical signs, symptoms, and complications can be associated with gestational choriocarcinoma. A high degree of clinical suspicion is essential for early diag-nosis, and high-risk GTN is uniquely sensitive to multi-drug chemotherapy with a high cure rate and survival.