Document Detail


Fertility-sparing surgery for persistent gestational trophoblastic neoplasia in the myometrium: a case report.
MedLine Citation:
PMID:  17583247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Persistently low-level "real" serum human chorionic gonadotropin (hCG) after treatment for gestational trophoblastic neoplasia (GTN) in patients desirous of preserving fertility is a diagnostic and management challenge. Among the possible explanations is the presence of false positive ("phantom") hCG or of trophoblasts in a myometrial sanctuary. CASE: An 18-year-old woman had persistent low-level hCG values in her serum after treatment for nonmetastatic GTN. Her only child had died, and she wanted to preserve her fertility potential. Phantom hCG was excluded. Positron emission tomography (PET) showed increased uptake in an area of the uterus in which magnetic resonance imaging had shown an ill-defined, ovoid lesion. Removal of the lesion with preservation of the uterus followed by 2 courses of multiagent chemotherapy (methotrexate, dactinomycin and cyclophosphamide) resuited in clinical remission. CONCLUSION: PET can prove useful in detecting persistent disease in a myometrial sanctuary in patients with resistant, nonmetastatic GTN. Conservative surgical excision with uterine preservation is possible and can be of value in achieving remission.
Authors:
Luis Rojas-Espaillat; Karen L Houck; Enrique Hernandez; Ross S Berkowitz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  52     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-06-22     Completed Date:  2007-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antineoplastic Combined Chemotherapy Protocols
Chorionic Gonadotropin / blood
Combined Modality Therapy
Diagnosis, Differential
Female
Fertility
Gestational Trophoblastic Neoplasms / blood,  diagnosis*,  pathology,  radiography,  surgery
Humans
Myometrium
Positron-Emission Tomography
Pregnancy
Uterine Neoplasms / blood,  diagnosis*,  pathology,  radiography,  surgery
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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