Urgent embolization of hemorrhagic choriocarcinoma liver metastases – case report and review of the literature

Lemańska, Agnieszka; Banach, Paulina; Stanisławska, Katarzyna; Juszkat, Robert; Spaczyński, Marek; Nowak‐Markwitz, Ewa

doi:10.17772/gp/57871

Cited by 4 publications

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“…Additionally, it has been suggested that the rapid development of choriocarcinoma within a mixed mediastinal germ cell tumor may be a contributing factor to tumor rupture and hemorrhage ( 1 ). Furthermore, chemotherapy might also play a role in precipitating tumor rupture ( 10 ). However, in the present case, the patient's tumor did not contain choriocarcinoma components, and no chemotherapy was administered prior to the rupture.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture‑induced life‑threatening mediastinal mixed germ cell tumor: A case report and therapeutic considerations

Li,

Xu,

et al. 2024

Oncol Lett

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Spontaneous rupture and hemorrhage of mediastinal germ cell tumors is a rare occurrence. In the current report, the case of a 20-year-old male patient who was admitted with chest tightness and dyspnea is presented. An urgent chest CT scan revealed a large tumor in the right anterior mediastinum, measuring ~12 cm in diameter, with associated intratumoral hemorrhage. An emergency thoracotomy was performed to excise the lesion, which revealed that the bleeding was caused by a ruptured tumor. Postoperative pathological findings revealed a mediastinal mixed germ cell tumor consisting of four pathological types: Embryonal carcinoma, seminoma, yolk sac tumor and immature teratoma. Postoperatively, the patient showed marked improvement in the symptoms of dyspnea. However, the follow-up outcome was poor, and the patient succumbed 2 months after surgery. To the best of our knowledge, there are no reports of rupture and hemorrhage involving >4 mixed germ cell tumors. In the present report, the experience of the treatment of the patient is summarized, and literature was reviewed to improve clinicians' awareness of the disease.

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Section: Discussionmentioning

confidence: 99%

Spontaneous rupture‑induced life‑threatening mediastinal mixed germ cell tumor: A case report and therapeutic considerations

Li,

Xu,

et al. 2024

Oncol Lett

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“…The highest risk of bleeding is at the beginning of chemotherapy due to the tumors high chemosensitivity resulting in rapid necrosis of the lesions ( 27 ). Instead of administering the standard EMA-CO regimen for our patient with a metastatic choriocarcinoma and a FIGO risk score of more than 7 (FIGO risk score = 14) ( 28 ), an initial single-agent chemotherapy with MTX before escalating it to EMA-CO regimen was decided upon. The rationale of this alternative approach was to reduce her risk of bleeding from the liver lesions by slowing down the rate of vascular necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…This similar strategy has also been described by Ding et al, in which a lower dose of chemotherapy with EP regimen (etoposide and cisplatin) was utilized in an antenatal mother to reduce the risk of massive bleeding from metastatic lesions, multiorgan failure and fetal complications ( 6 ). The emergency treatment option for massive bleeding from liver metastases is a selective temporal catheterization of the arteries supplying the metastases, which is considered a safer and more efficient method of bleeding control than packing or suturing ( 27 , 28 ). Nevertheless, an arterial embolization does not completely eliminate the risk of recurrent bleeding.…”

Section: Discussionmentioning

confidence: 99%

Choriocarcinoma complicated with intra-abdominal and intrapleural hemorrhage in pregnancy – case report

Jaz,

Miedziarek,

Piasek

et al. 2023

Front. Oncol.

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BackgroundChoriocarcinoma is a rare neoplasm, exceptionally uncommon during an ongoing pregnancy. The disease often has a metastatic character, causing severe symptoms from various anatomic sites like the lungs, central nervous system, vagina, pelvis, or liver. Due to the condition’s rarity, evidence on how to treat the choriocarcinoma originating during pregnancy remains scarce.Case presentationHere, we present a case of a patient who developed choriocarcinoma before the 29th week of gestation. The neoplasm had a metastatic character, resulting in hemorrhage complicated by a hypovolemic shock. The patient underwent an emergency cesarean section and several surgeries to stop the massive hemorrhage. The treatment of the choriocarcinoma included chemotherapy with methotrexate followed by an EMA-CO regimen. The patient had a complete response to the therapy. The neonate suffered from complications related to prematurity.ConclusionMetastatic choriocarcinoma can be a diagnostic and therapeutic challenge during ongoing pregnancy. Treatment of the disease can be associated with severe complications, but a complete response to chemotherapy is possible with a favorable long-term prognosis.

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“…Lewis et al reported that the most common reason for surgery is haemorrhage control (16). Embolization is the preferred choice of treatment to control bleeding in liver metastasis (17). Metastases to the brain have a poorer prognosis (18).…”

Section: Discussionmentioning

confidence: 99%

A rare case of metastatic choriocarcinoma to multiple organs causing intractable bleeding.

Tan¹,

Tay²,

Chan³

2016

Cancer Res Front

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Urgent embolization of hemorrhagic choriocarcinoma liver metastases – case report and review of the literature

Cited by 4 publications

References 0 publications

Spontaneous rupture‑induced life‑threatening mediastinal mixed germ cell tumor: A case report and therapeutic considerations

Spontaneous rupture‑induced life‑threatening mediastinal mixed germ cell tumor: A case report and therapeutic considerations

Choriocarcinoma complicated with intra-abdominal and intrapleural hemorrhage in pregnancy – case report

A rare case of metastatic choriocarcinoma to multiple organs causing intractable bleeding.

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