Cesarean section scar choriocarcinoma, an unusual entity with ultrasound, MRI and pathologic correlation

Gromis, Jonathan; Lee, Cheng‐Han; Beltre, Melba; Khan, Fahad; Tenzel, Nicole; Zakashansky, Konstantin; Kamath, Amita

doi:10.1016/j.clinimag.2018.09.018

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…Zhou et al [ 7 ] reported 2 cases: a case of cesarean scar GTN and a case of CSP; both cases were misdiagnosed by ultrasound at first, but MRI led to the correct diagnosis. Gromi [ 8 ] made the GTD diagnosis by ultrasound at the first examination because the mass showed the typical snowstorm sign.…”

Section: Discussionmentioning

confidence: 99%

Case report: Two rare uterine cesarean scar mass cases

et al. 2023

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Rationale: Gestational trophoblastic neoplasia (GTN) located in the cesarean scar is a rare disease that has imaging appearances similar to those of an exogenous scar incision pregnancy and is often misdiagnosed due to insufficient clinical experience. Patient concerns: We report 2 cases of uterine cesarean scar mass. Two patients with different diagnoses had similar clinical complaints as abnormal vaginal bleeding, enlargement of uterus isthmus by physical examination, and mixed echo mass in uterine low segment by ultrasound examination; however, their magnetic resonance imaging images showed very different features. Diagnoses: One patient was diagnosed with cesarean scar pregnancy (CSP) and one patient was diagnosed with cesarean scar GTN. Interventions: The CSP patient underwent surgery by laparoscopy combined with hysteroscopy after uterine artery embolism and obtained pathological confirmation. The GTN patient received chemotherapy. Outcomes: For the CSP patient, her serum β-human chorionic gonadotropin (hCG) concentration returned to normal 2 weeks later, and B-ultrasound showed that the niche was completely repaired 3 months after the operation. The intrauterine lesions of the GTN patient disappeared completely 3 months after serum β-hCG normalization. And her β-hCG was normal at all follow-up visits until now. Lessons: Clinicians should consider GTN when identifying masses at scar incision sites. Magnetic resonance imaging images improve the understanding of the imaging features in patients suspected of having CSP/GTN.

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Section: Discussionmentioning

confidence: 99%

Case report: Two rare uterine cesarean scar mass cases

et al. 2023

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“…In addition, due to the patient's prolonged bed rest after surgery and the high amount of postpartum blood loss, their pelvic floor muscle tone recovered slowly, which further affected the uterine contraction, so it was important to accelerate the postoperative uterine involution. In the study by scholars Gromis et al, it was shown that, at postoperative days 5 and 42, the size of uterus of patients undergoing C-section who accepted the low-frequency electric pulse treatment was 25.37 ± 1.28 and 16.73 ± 1.03, respectively [ 25 ], indicating that such treatment could accelerate the involution of uterus. In this study, after applying the low-frequency electric pulse treatment, patients in the experimental group had significantly better involution of uterus ( P < 0.001), shorter duration of lochia, and significantly lower incidence rates of retention of urine, deep venous thrombosis of lower limb, rupture of uterus, and endometrial cavity fluid than the control group ( P < 0.05), proving that combining carboprost methylate suppositories with low-frequency electric pulse technique had a more desirable and comprehensive effect.…”

Section: Discussionmentioning

confidence: 99%

Effect of Low-Frequency Electric Pulse Technique Combined with Carboprost Methylate Suppositories on Recovery of Gastrointestinal Function and Postoperative Complications of Patients with Scarred Uterus Undergoing Secondary Cesarean Section

Yan

Liu

Jiao

et al. 2021

Journal of Healthcare Engineering

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The study aims to explore the effect of low-frequency electric pulse technique combined with carboprost methylate suppositories on recovery of gastrointestinal function and postoperative complications of patients with scarred uterus undergoing secondary cesarean section (C-section). The clinical data of 120 patients with scarred uterus undergoing secondary C-section treated in our hospital from February 2019 to February 2020 were retrospectively analyzed, and the patients were equally divided into experimental and control groups according to their admission order, where each group included 60 patients. After the operation, patients in the control group received routine nursing and conducted breastfeeding, and carboprost methylate suppositories were used for postoperative hemostasis. Those in the experimental group received low-frequency electric pulse technique for comprehensive treatment to compare their coagulation function indicators, recovery of gastrointestinal function, incidence rates of postoperative complications, and involution of uterus. No significant between-group differences in patients’ general information such as gestational weeks, gravidity, and number of times receiving C-section were observed ( P > 0.05 ). Compared with the control group after the operation, patients in the experimental group obtained significantly better coagulation function indicators ( P < 0.001 ) and presented better gastrointestinal function recovery ( P < 0.001 ), significantly lower incidence rates of postpartum hemorrhage, retention of urine, deep venous thrombosis of lower limb, rupture of uterus, and endometrial cavity fluid ( P < 0.05 ), and significantly better involution of uterus ( P < 0.001 ). In conclusion, combining low-frequency electric pulse technique with carboprost methylate suppositories can lower the incidence rates of postoperative complications for patients with scarred uterus undergoing secondary C-section, improve their coagulation function, promote the recovery of gastrointestinal function, and present the desirable involution of uterus, which should be promoted in practice.

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“…Уровень β-ХГЧ более 100 тыс. мМЕ/мл чаще встречается при ИПЗ и ХК [35]. Концентрация ХГ в сыворотке крови коррелирует с массой опухоли.…”

Section: методы диагностики тбunclassified

Modern approaches to the diagnosis of malignant trophoblastic tumors

Mamedli

кызы²,

Чекалова

et al. 2021

J. Mod. Onco.

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Malignant trophoblastic tumors (TO) include invasive and metastatic cystic drift, choriocarcinoma, TO of the placental bed, and epithelioid TO. They are rare, mainly in women of reproductive age, and most importantly, they are always associated with pregnancy. To date, the Blokhin National Medical Research Center of Oncology has accumulated a large and unique experience of modern diagnostics and treatment of patients with various forms of malignant TO. An obligatory stage of the examination is ultrasound diagnostics of the pelvic organs. In addition, performing an ultrasound examination during the treatment period, along with monitoring the level of chorionic gonadotropin, makes it possible to assess the effectiveness of treatment, diagnose tumor resistance and ascertain the onset of remission.

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Cesarean section scar choriocarcinoma, an unusual entity with ultrasound, MRI and pathologic correlation

Cited by 5 publications

References 25 publications

Case report: Two rare uterine cesarean scar mass cases

Case report: Two rare uterine cesarean scar mass cases

Effect of Low-Frequency Electric Pulse Technique Combined with Carboprost Methylate Suppositories on Recovery of Gastrointestinal Function and Postoperative Complications of Patients with Scarred Uterus Undergoing Secondary Cesarean Section

Modern approaches to the diagnosis of malignant trophoblastic tumors

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