Gestational Trophoblastic Neoplasms

Hui, Pei

doi:10.1007/978-3-030-84725-8_29

Cited by 2 publications

(6 citation statements)

References 171 publications

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“…In patients with low‐risk (<7), choriocarcinoma histology has been reported to be associated with single‐drug resistance 9,14,15 . Therefore, in some cases with choriocarcinoma, a risk score of 5 or 6, or the presence of metastases who have experienced resistance or relapse after first‐line single‐agent CT, multi‐agent CT may be considered 5,31–34 …”

Section: Discussionmentioning

confidence: 99%

“…GCC is a unique type of gestational trophoblastic neoplasia (GTN) occurring in 1:40,000–50,000 pregnancies, which develops following any type of pregnancy, mostly hydatidiform mole (50%), term or pre‐term deliveries (25%), ectopic pregnancy, or abortion (25%). However, only 2%–3% of hydatidiform moles progress to choriocarcinoma 3–5 …”

Section: Introductionmentioning

confidence: 99%

“…It is histologically characterized by a mixture of cytotrophoblast and syncytiotrophoblastic hyperplasia, necrosis, and hemorrhage in the absence of chorionic villi 1,4,6 . Due to its trophoblastic affinity to the vessel, it disseminates hematogeneously and thereby tends to involve higher rates of distant metastasis even at an early stage so it can be related to necrosis and hemorrhagia in adjacent tissues 4,5 . Although it is an aggressive malignancy, chemotherapy (CT) has provided cure rates approaching 90%, even in the presence of extensive metastasis due to its high sensitivity to CT 7–10 .…”

Section: Introductionmentioning

confidence: 99%

“…the vessel, it disseminates hematogeneously and thereby tends to involve higher rates of distant metastasis even at an early stage so it can be related to necrosis and hemorrhagia in adjacent tissues. 4,5 Although it is an aggressive malignancy, chemotherapy (CT) has provided cure rates approaching 90%, even in the presence of extensive metastasis due to its high sensitivity to CT. [7][8][9][10] Histological diagnosis of GCC without the requirement of plateau or increasing β-human chorionic gonadotropin (β-hCG) is crucial for immediate initiation of CT. 11,12 Although the histological diagnosis of GCC is not included in the International Federation of Gynecology and Obstetrics (FIGO) scoring system, it has been reported in some studies to be associated with poor response to initial CT. 9,[13][14][15][16][17] FIGO scoring could be taken into consideration together with the histopathological diagnosis when making the decision for the appropriate CT regimen in GCC.…”

mentioning

confidence: 99%

“…5,[31][32][33][34] Bolze et al reported that hysterectomy as a first-line treatment is effective without salvage CT in women with low-risk GTN and can be presented as an alternative to single-agent CT 14. …”

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confidence: 99%

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Clinical features of gestational choriocarcinoma: A retrospective bicentric study

Yüksel

Aytekın

Oktar

et al. 2023

Asia-Pac J Clncl Oncology

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ObjectiveTo investigate the clinicopathological features, prognostic factors, treatment, clinical response, and outcome of gestational choriocarcinoma (GCC).Materials and methodsA retrospective review was made of the clinicopathological and survival data of 13 patients who were diagnosed and treated for GCC in two referral centers in Turkey between 1992 and 2020.ResultsThe median age of patients was 36 years (range, 27–54 years), and seven were ≤39 years. The antecedent pregnancy was a term in nine (69.2%) cases, and the risk score was ≥7 in 11 (84.6%). According to the International Federation of Gynecology and Obstetrics 2009 staging, eight cases were in stage I, two in stage III, and three in stage IV. With the exception of one patient, all the others received combination chemotherapy (CT), and two of those were also treated with radiotherapy. Chemoresistance developed in 50% (6/12), and second‐line CT was given to four of these. The overall complete response rate was 69.2%. Four patients died of chemoresistance and disease progression, all of them were with antecedent‐term pregnancy, had high scores ≥7, and had metastases.ConclusionGCC is a unique subtype of gestational trophoblastic neoplasia, which differs from others in terms of poor prognosis, a frequent tendency to early metastasis, and resistance to treatment. To be able to achieve the most efficient therapy and prognosis, histopathology‐based risk models should be developed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Clinical features of gestational choriocarcinoma: A retrospective bicentric study

Yüksel

Aytekın

Oktar

et al. 2023

Asia-Pac J Clncl Oncology

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A Case Report of a Rare Cause of Diagnostic Dilemma in the Management of Gestational Choriocarcinoma

Muhammad,

Aminu,

Dattijo

et al. 2024

Sch Int J Obstet Gynec

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Choriocarcinoma belongs to one extreme of molar pregnancy, the other end is hydatidiform mole. It is a fast-growing tumor that occurs in a woman’s uterus but can easily metastasize to the lungs, liver, and brain. The abnormal tumor cells start in the tissue that would normally become the placenta. Choriocarcinoma developed after a normal pregnancy in 1 in 50,000, miscarriages in 1 in 15,000, and complete mole 1 in 40. The tumor may mimic uterine fibroid, especially when it presents as a uterine mass (which is not the common presentation) posing an initial diagnostic dilemma, as seen in our patient. The patient was an 18years P0+1 whose last normal menstrual period was a year before presentation. She presented with a history of loss of 14-week conception, then followed by 11months history of abnormal scanty vaginal bleeding lasting 21-27 days monthly, the patient was found to be mildly pale but had stable vital signs, she had a uterine mass of about 22weeks size, abdominal ultrasound scan revealed uterine fibroid. In the process of investigation serum pregnancy test was done and was found to be positive, with markedly elevated serum beta hcg. We made an assessment of choriocarcinoma and we commenced her on chemotherapy, she received 4 courses but with no decline in beta HCG. She had a total abdominal hysterectomy and histology confirmed choriocarcinoma, serum beta HCG was then immediately noticed to decline, she had further chemotherapy, and the patient did well subsequently. Huge choriocarcinoma may be mistaken for uterine fibroid, hence a high index of suspicion for choriocarcinoma is important if a patient presents with a recent history of miscarriage, uterine mass, vaginal bleeding, and a positive pregnancy test.

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Gestational Trophoblastic Neoplasms

Cited by 2 publications

References 171 publications

Clinical features of gestational choriocarcinoma: A retrospective bicentric study

Clinical features of gestational choriocarcinoma: A retrospective bicentric study

A Case Report of a Rare Cause of Diagnostic Dilemma in the Management of Gestational Choriocarcinoma

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