Gestational trophoblastic diseases: 4. Presentation with persistent low positive human chorionic gonadotropin test results

Cole, Laurence A.; Khanlian, Sarah A.; Giddings, Almareena; Butler, Stephen A.; Muller, Carolyn Y.; Hammond, Charles B.; Kohorn, Ernest I.

doi:10.1016/j.ygyno.2005.12.048

Cited by 46 publications

(60 citation statements)

References 9 publications

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“…12Y15,17,18 False-positive hCG was first ruled out by measuring total hCG in the presence and absence of heterophilic antibodyblocking agent HBR (Scantibodies Inc, San Diego, CA), and measuring hCG in both serum and urine samples. 6,10 It was only after excluding false-positive hCG, gestational trophoblastic neoplasm, and nontrophoblastic neoplasm as potential sources of patient's hCG that pituitary hCG was considered. Pituitary hCG required medical records showing patients to be in perimenopause or menopause or to have had bilateral oophorectomy.…”

Section: Methodsmentioning

confidence: 99%

Normal Production of Human Chorionic Gonadotropin in Perimenopausal and Menopausal Women and After Oophorectomy

Cole

Khanlian

Muller

2009

Int J Gynecol Cancer

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Low-level hCG production in woman in physiologic perimenopause, in menopause, or in women with prior bilateral oophorectomy is a normal biologic and biochemical phenomenon. Management protocols in all fields need to be changed to accept pituitary hCG as normal and recognize the clinical maneuvers that will secure the diagnosis. Understanding this physiology will avoid needless delays in necessary therapies such as organ transplant procedures and will limit the misadventure of prescribing unnecessary cancer treatments.

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Section: Methodsmentioning

confidence: 99%

Normal Production of Human Chorionic Gonadotropin in Perimenopausal and Menopausal Women and After Oophorectomy

Cole

Khanlian

Muller

2009

Int J Gynecol Cancer

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“…Si on considère la combinaison du groupe maternel et celui du conjoint, le risque de môle hydatiforme est très élevé chez une femme du groupe sanguin « A » avec un conjoint du groupe « O » ou « A » [56,57]. D'autres études ne trouvent aucune relation entre le groupe sanguin ABO et l'incidence de la môle hydatiforme [58].…”

Section: éPidémiologieunclassified

“…Le dosage du ␤hCG constitue un élément important aussi bien diagnostic que pronostic et de surveillance, quoiqu'un taux normal de ce marqueur n'exclue nullement une môle hydatiforme [63][64][65][66]. Dans notre série, le taux de ␤hCG était augmenté par rapport à l'âge gestationnel dans 75 % des cas.…”

Section: Diagnostic Positifunclassified

“…Horn et al [3] ont rapporté un risque plus élevé d'avortement, essentiellement si la grossesse a eu lieu dans les six mois suivant l'évacuation môlaire et une nouvelle grossesse précoce risque de retarder le diagnostic d'une éventuelle tumeur trophoblastique gestationnelle postmôlaire en obscurcissant le monitoring du ␤hCG [65,66,77]. Un délai d'une année assorti d'une contraception dont le choix doit être discuté avec la patiente semble la norme à respecter.…”

Section: Fertilité Et Récidive Après Môle Hydatiforme Complèteunclassified

See 1 more Smart Citation

Les môles hydatiformes complètes au Maroc : étude épidémiologique et clinique

Boufettal

Coullin

Mahdaoui

et al. 2011

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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“…Any incidental pelvic mass may also be found with: a false-positive hCG result (most commonly anti-animal antibodies)14; quiescent gestational trophoblastic disease15; pituitary hCG found in perimenopausal and postmenopausal women14; exogenous hCG use in assisted reproductive technology or misuse in athletes or weight-loss programmes14 16; trophoblastic differentiation in any cancer (lung, biliary, bladder, sarcoma, gastrointestinal) 17…”

Section: Differential Diagnosis Of a Pelvic Mass On Ultrasonography Amentioning

confidence: 99%

A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy

Rozenholc¹,

Abdulcadir

Pelte

et al. 2012

Case Reports

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A 24-year-old patient with 7-week amenorrhoea consulted for vaginal bleeding without abdominal pain. Ultrasonography revealed a 7 × 4 cm solid right pelvic mass. There was no visible intrauterine gestational sac. The serum β-human chorionic gonadotropin (β-hCG) level was 11 998 IU/l. Emergency laparoscopy was performed for a presumptive diagnosis of ectopic pregnancy. At laparoscopy, the right ovary was enlarged with a non-haemorrhagic 7 × 4 cm solid lesion, which was resected. The histological diagnosis was a dysgerminoma with immunohistochemistry showing nests of syncytiotrophoblastic cells, which were the origin of the hCG production. There was no pregnancy, either intrauterine or ectopic. There was no evidence of metastasis from the dysgerminoma on the positron-emission tomography scanner. The patient underwent a second procedure for surgical staging of this ovarian germ-cell tumour. This ovarian dysgerminoma was staged FIGO 1A, and the patient did not receive adjuvant therapy. There was no recurrence at the last 8-month follow-up.

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Gestational trophoblastic diseases: 4. Presentation with persistent low positive human chorionic gonadotropin test results

Cited by 46 publications

References 9 publications

Normal Production of Human Chorionic Gonadotropin in Perimenopausal and Menopausal Women and After Oophorectomy

Normal Production of Human Chorionic Gonadotropin in Perimenopausal and Menopausal Women and After Oophorectomy

Les môles hydatiformes complètes au Maroc : étude épidémiologique et clinique

A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy

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