Choriocarcinoma is a highly malignant trophoblastic neoplasia, arising following any type of pregnancy. Even though choriocarcinoma has an early haematogenous metastasis to multiple organs, spinal metastasis is extremely rare. A 28-year-old woman presented with a two-week history of progressive numbness and weakness of the lower limbs and difficulty in walking. In magnetic resonance imaging of the spine, soft tissue components were noted adjacent to the spinal cord. She underwent laminectomy to remove the extramedullary located tumour mass, which was compressing the spinal cord. Although there was a significant improvement in tactile stimulation in the lower limb following six courses of multi-agent chemotherapy, she continued to have leg weakness. Despite improvements in treatment modality and the use of combined modality treatment with chemotherapy, surgery, and radiation, the prognosis for this choriocarcinoma with spinal metastasis is unfavourable. Earlier diagnosis and multimodality treatment is crucial for a significant reduction in mortality and morbidity.
Congenital heart block (CHB) is a cardiac disease with an overall prevalence of approximately1:20000 live births. Structural heart defects, congenital malformations of the cardiac conduction system, maternal connective tissue disorders and fetal myocarditis are the main entities that can cause CHBs. Here we report three cases of congenital heart blocks due to three different pathologies and their outcomes. In the first case, we could not detect a structural pathology for congenital heart block; however, in second and third cases there were significant structural cardiac defects that could contribute to the fetal bradycardia. Prenatal management of fetal arrhythmia may improve the outcome of an affected fetus or neonate. Precise and timely prenatal diagnosis is critical for the selection of the appropriate prenatal treatments. However, there are many limitations in managing CHB even today and more useful strategies need to be investigated.
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