Clinical Outcome of a FIGO Stage IV Gestational Choriocarcinoma

Milenkovic, V.; Lazović, Biljana; Mačvanski, Marija; Jeremić, K.; Hrgović, Zlatko

doi:10.1159/000353626

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…The patient was not eligible for surgical treatment of the tumors due to poor general condition, so it could not be confirmed whether the patient exhibited NGCO or GCO with multiple lung, skull, neck, lymph node and skin metastases. The most common sites for choriocarcinoma metastases are the lungs and vulvovaginal region, followed by the brain and liver (14). Alternative sites of metastasis, including the skin, gastrointestinal tract, kidney, breast and bone, are rarely observed (15).…”

Section: Discussionmentioning

confidence: 99%

Choriocarcinoma with multiple lung, skull and skin metastases in a postmenopausal female: A case report

Liu

2015

Oncology Letters

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Abstract. Gestational trophoblastic disease with a primary extra-uterine nidus is rare, particularly during the postmenopausal period. The present report outlines a case of high-risk choriocarcinoma (International Federation of Gynecology and Obstetrics stage IV; World Health Organization score 13) in a 68-year-old female exhibiting neoplasm. The choriocarcinoma developed 20 years subsequent to the onset of menopause and 42 years following the patient's final pregnancy, and was associated with multiple metastases to the lungs, skull, neck, lymph nodes and skin. The patient was administered two courses of systemic chemotherapy with tegafur (800 mg) and actinomycin D (200 µg). Local chemotherapy was also administered to the scalp and left flank masses; the masses were injected first with methotrexate, and then with 5-fluorouracil. During chemotherapy, the patient's levels of β-human chorionic gonadotrophin (β-HCG) decreased from 3,171 IU/l to 1,763 IU/l, however by the conclusion of the courses of systemic and local chemotherapy, β-HCG levels had increased to 3,704 IU/l. The patient and their family subsequently elected to end treatment. The patient subsequently succumbed to infection, tumor consumption and organ insufficiency. This study describes the clinical and radiological features, as well as the treatment used for this rare type of choriocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Choriocarcinoma with multiple lung, skull and skin metastases in a postmenopausal female: A case report

Liu

2015

Oncology Letters

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“…Patients with score < 7 were considered low-risk, whereas patients with score 7 or more were considered high-risk group [5]. [20]. Prevalence of liver metastasis from GTN is approximately 1.8% -3.4% [21].…”

Section: Resultsmentioning

confidence: 99%

Gestational Trophoblastic Neoplasia: Clinical and Therapeutic Profile in Madagascar

Randriamaroson¹,

Razakanaivo²,

Andrianandrasana³

et al. 2020

OJOG

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Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. This includes complete and partial hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN). The aim of this study was to report the epidemiological, clinical and therapeutic profile of gestational trophoblastic neoplasia (GTN) over period of ten years in the department of Oncology Radiotherapy at the University Hospital Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo Madagascar. Medical records of women diagnosed with GTD in the department of Oncology Radiotherapy at HJRA from January 1st, 2007 to September 2017 were retrospectively reviewed. Only patients with the FIGO diagnosis GTN were included, while those with the histological diagnosis of hydatidiform mole (HM), also sometimes classified as GTD, were not included in this study. Also excluded were all cases with incomplete or missing data. Twenty four patients were included. Median age of patients at the time of diagnosis was 37 years (range 18-60). Most patients developed GTN following molar pregnancy (75%), had disease duration from antecedent pregnancy of less than 6 months (58.20%), and had the pre-treatment hCG level more than 10,000 IU/L (58.27%). At diagnosis, 14 patients (58.33%) had localized disease (M0). Most common metastatic sites at initial diagnosis were the liver and brain (20.83%). After a median follow-up from initial diagnosis of six months (range 1-24), 58.33% were lost to follow up. This represented an increase in the percentage of patients lost to follow up prior to completion of therapy, when compared with our previous results for an earlier time period. GTN in Malagasy woman displays an aggressive clinic profile. Finding ways to increase treatment compliance provides the best way to minimize recurrences of this potentially deadly disease.

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“…Choriocarcinoma is characterized by marked neoangiogenesis, early and extensive vascular invasion resulting in high tendency to metastasize through the hematogenous route even when the primary tumor is quite small or not detectable. Metastasis commonly spreads to the lung (80%), followed by vagina (30%), brain (10%), and liver (10%) [13] . It may also metastasize to kidney, gastrointestinal tract, skin, or fetus but isolated metastasis to other sites is rare in the absence of lung metastasis [12] .…”

Section: Discussionmentioning

confidence: 99%

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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Gestational choriocarcinoma is a malignant trophoblastic tumor arising from any gestational event, even with a long latency period, generally in the reproductive female. It is associated with a high level of beta-human chorionic gonadotropin. Its primary site is usually the uterus but not all patients have a detectable lesion in this site. Regression of the primary tumor after it has metastasized is not uncommon, and one-third of cases manifest as complications of metastatic disease. In this report we present an uncommon case of gestational choriocarcinoma with lung, liver and jejunal metastases at the time of diagnosis without evidence of pelvic disease, in 34-year-old woman. The main points of interest of our case were the development of the ovarian hyperstimulation syndrome with massive multicystic ovarian enlargement induced by high level of beta-human chorionic gonadotropin and the bleeding of jejunal and liver metastases, due to the high vascularity of the tumor tissue, a condition known as “Choriocarcinoma Syndrome”. We will focus on the radiological findings of metastases, bleeding complications and ovarian hyperstimulation syndrome.

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Clinical Outcome of a FIGO Stage IV Gestational Choriocarcinoma

Cited by 6 publications

References 8 publications

Choriocarcinoma with multiple lung, skull and skin metastases in a postmenopausal female: A case report

Choriocarcinoma with multiple lung, skull and skin metastases in a postmenopausal female: A case report

Gestational Trophoblastic Neoplasia: Clinical and Therapeutic Profile in Madagascar

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

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