Document Detail


The role of hysterotomy in the management of gestational trophoblastic neoplasia.
MedLine Citation:
PMID:  16681777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of late gestational trophoblastic disease recurrence is challenging. We present a case of a 16-year-old woman who was diagnosed with a gestational trophoblastic neoplasia 14 months after her hydatidiform mole pregnancy. A staging was performed revealing only an intramural lesion, which resembled a myoma, in the fundus of the uterus. Despite two course of methotrexate, the human chorionic gonadotropin (hCG) level increased slowly. The presentation was highly suggestive for a placental site trophoblastic tumor. A local resection of the tumor by hysterotomy was performed. Pathologic examination revealed a choriocarcinoma with tumor-free surgical margins. Subsequently, the patient received three cycles of EMA-CO (etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine). At present, 89 months after the hysterotomy, the patient is well, with no sings of recurrence. This report illustrates that it is mandatory to have a histologic diagnosis of chemoresistant gestational trophoblastic neoplasia before performing definitive surgery.
Authors:
W A A Tjalma; J B Vermorken
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  16     ISSN:  1048-891X     ISO Abbreviation:  Int. J. Gynecol. Cancer     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-05-09     Completed Date:  2006-10-12     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  882-3     Citation Subset:  IM    
Affiliation:
Department of Gynecology, University Hospital Antwerpen (UZA), Antwerpen, Belgium. wiebren.tjalma@uza.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Cyclophosphamide / therapeutic use
Dactinomycin / therapeutic use
Etoposide / therapeutic use
Female
Gestational Trophoblastic Neoplasms / diagnosis,  drug therapy,  surgery*
Humans
Hysterotomy*
Methotrexate / therapeutic use
Pregnancy
Uterine Neoplasms / diagnosis,  drug therapy,  surgery*
Vincristine / therapeutic use
Chemical
Reg. No./Substance:
0/EMA-CO protocol; 33419-42-0/Etoposide; 50-18-0/Cyclophosphamide; 50-76-0/Dactinomycin; 57-22-7/Vincristine; 59-05-2/Methotrexate

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


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