Role of Hysterectomy in Gestational Trophoblastic Neoplasia

Ramesan, Chiyancheri Koroth; Thomas, Dhanya Susan; Sebastian, Ajit; Thomas, Vinotha; Thomas, Anitha; George, Rachel; Peedicayil, Abraham

doi:10.1007/s13193-021-01328-2

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…Because of the high effectiveness of chemotherapy, hysterectomy is not highly recommended [ 7 ]. However, in selected patients, it is believed to help in reducing the cycles of chemotherapy, overcoming chemo-resistance, and treating acute haemorrhagic events [ 15 ]. Hysterectomy is not usually recommended at the beginning of treatment with high level of hCG, unless there is uterine perforation and/or uncontrollable bleeding [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon: a case report and literature review

Sun

Jiang

et al. 2023

BMC Women's Health

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Background Gestational trophoblastic neoplasia (GTN) is rare, and it is even rarer for GTN to merge with primary malignant tumors in other organs. Herein is described a rare clinical case of GTN combined with primary lung cancer and mesenchymal tumor of the sigmoid colon, followed with literature review. Case presentation The patient was hospitalized due to diagnosis of GTN with primary lung cancer. Firstly, two cycles of chemotherapy including 5-fluorouracil (5-FU) and actinomycin-D(Act-D) was given. Laparoscopic total hysterectomy and right salpingo-oophorectomy was performed during the third chemotherapy. During the operation, a 3*2 cm nodule was removed which was protruded from the serous surface of the sigmoid colon, and the nodule was confirmed mesenchymal tumor pathologically, in accord with gastrointestinal stromal tumor. During the treatment of GTN, Icotinib tablets were taken orally to control the progression of lung cancer. After 2 cycles of consolidation chemotherapy of GTN, she received thoracoscopic lower lobe of right lung lobectomy and the mediastinum lymph nodes removal. She undertook gastroscopy and colonoscopy and the tubular adenoma of the descending colon was removed. At present, the regular follow-up is taken and she remains free of tumors. Conclusions GTN combined with primary malignant tumors in other organs are extremely rare in clinical practice. When imaging examination reveals a mass in other organs, clinicians should be aware of the possibility of a second primary tumor. It will increase the difficulty of GTN staging and treatment. We emphasis the importance of the collaboration of multidisciplinary teams. Clinicians should choose a reasonable treatment plan according to the priorities of different tumors.

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Section: Discussionmentioning

confidence: 99%

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon: a case report and literature review

Sun

Jiang

et al. 2023

BMC Women's Health

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“…8 Another study by C. K. Ramesan et al reported from South India, more hysterectomies were done in the highrisk group cases for either intra peritoneal bleeding or vaginal bleeding, mostly diagnosed as choriocarcinoma or invasive mole and chemotherapy cycles were given in those patients. 9 They suggested hysterectomy as a way to reduce tissue bulk and thus reduce chemoresistance. Ngan HY et al in their report have mentioned risk scores of 5-6 are more chemo-resistant requiring multiple agents for chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Successful management of vascular invasive mole by uterine artery embolization and hysterectomy - A case report

Devalla¹,

Kalra²,

Kumar³

et al. 2023

IJOGR

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Gestational Trophoblastic Neoplasia (GTN) is a rare disease originating from pregnancy events that have varied incidences and clinical manifestations based on regional variation. We are reporting a case of a 36-year-old woman with Invasive mole from Central India who presented with abnormal uterine bleeding with severe anemia. She had three full-term vaginal deliveries and 2 spontaneous abortions, the last conception being an abortion around 7 years back. MRI pelvis demonstrated a hypervascular uterine mass suggestive of an Invasive Mole, supported by increased serum β-hCG levels of 31.8 IU/ml. There was no evidence of any metastases on adjunct radiological investigations. After a thorough counselling, the enlarged vascular uterine mass was managed by uterine artery embolization (UAE) followed by simple hysterectomy. Histopathology report confirmed the diagnosis of invasive mole with villi lying in the fibrinous blood clot sheath of the syncytial, and cytotrophoblasts were seen invading the myometrium foci. The patient being in the low risk FIGO scoring, calculated was 5, chemotherapy was not deemed necessary for the patient. Serial post operative β-hCG along with ultrasound pelvis and chest radiogram surveillance showed favourable results with no evidence of metastases even on 6 months follow up. Being a very rare condition, a high index of suspicion with prompt timely management ensures optimum care.

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“…Because of the high effectiveness of chemotherapy, hysterectomy is not highly recommended [14] . However, in selected patients, it is believed to help in reducing the cycles of chemotherapy, overcoming chemo-resistance, and treating acute haemorrhagic events [15] . Hysterectomy is not usually recommended at the beginning of treatment with high level of hCG, unless there is uterine perforation and/or uncontrollable bleeding [16] .…”

Section: Discussionmentioning

confidence: 99%

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon:a case report and literature review

Sun

Jiang

et al. 2022

Preprint

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Background Gestational trophoblastic neoplasia(GTN) is rare, and it is even rarer for GTN to merge with primary malignant tumors in other organs. The clinical data of one case of GTN combined with primary lung cancer and mesenchymal tumor of the sigmoid colon were retrospectively analyzed, and summarized by reviewing relevant literature. To explore the incidence, diagnosis and treatment of GTN combined with primary malignant tumors in other organs. Case presentation The patient was hospitalized due to diagnosis of GTN with primary lung cancer. Firstly, two cycles of chemotherapy including 5-fluorouracil (5-FU) and actinomycin-D(Act-D) was given. Laparoscopic total hysterectomy and right salpingo-oophorectomy was performed during the third chemotherapy. During the operation, a 3*2cm nodule was removed which was protruded from the serous surface of the sigmoid colon, and the nodule was confirmed mesenchymal tumor pathologically, in accord with gastrointestinal stromal tumor. During the treatment of GTN, Icotinib tablets were taken orally to control the progression of lung cancer. After 2 cycles of consolidation chemotherapy of GTN, she received thoracoscopic lower lobe of right lung lobectomy and the mediastinum lymph nodes removal. She undertook gastroscopy and colonoscopy and the tubular adenoma of the descending colon was removed. At present, the regular follow-up is taken and she remains free of tumors. Conclusion GTN combined with primary malignant tumors in other organs are extremely rare in clinical practice and will increase the difficulty of GTN staging and treatment, and bring more challenges to clinicians. It should be emphasized to make comprehensive judgment, and choose a reasonable treatment plan according to the priorities of different tumors.

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Role of Hysterectomy in Gestational Trophoblastic Neoplasia

Cited by 7 publications

References 8 publications

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon: a case report and literature review

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon: a case report and literature review

Successful management of vascular invasive mole by uterine artery embolization and hysterectomy - A case report

Gestational trophoblastic neoplasia with primary lung cancer and mesenchymal tumor of sigmoid colon:a case report and literature review

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