Video-assisted thoracoscopic surgery for pulmonary metastasis of gestational trophoblastic neoplasia

Abstract

Gestational trophoblastic neoplasm (GTN) is prone to pulmonary metastasis. Although most pulmonary metastatic lesions response with chemotherapy, some lesions do not resolve and persist on radiologic investigations. A 25-year-old women was referred for persistent pulmonary metastatic lesion of GTN. Here, we present a case of chemo-resistant choriocarcinoma metastatic to lung managed by video-assisted thoracoscopic surgery.Key Words: Gestational trophoblastic neoplasm, Thoracic surgery, Video-assistedGestational trophoblastic neoplasm (GTN) tends to hematogenous metastasis, especially to the lungs.After several courses of chemotherapy, residual pulmonary lesions have to be managed with further treatments.The role of surgery for pulmonary metastasis is not fully defined. Thoracotomy sometimes has played a role in the management of pulmonary metastasis.Prior series have reported a wide range for the rate of surgery for pulmonary metastasis in choriocarcinoma ranging from 1% to 17%. 1As a result of advances in surgical technique, resection of pulmonary metastasis can be accomplished in a less invasive manner with thoracoscopic surgery.We present a case of chemo-resistant choriocarcinoma metastatic to lung managed by video-assisted thoracoscopic surgery. Case reportThe patient is 25-year-old gravida 2 para 0 women. She had a past history of two spontaneous abortion. She visited to a local clinic in 1/25/2005 for amenorrhea for 7 weeks. Her serum β-human chorionic gonadotropin (β-hCG) was 311 mIU/mL. On pelvic ultrasonography, she had a normal appearance of uterus, fallopian tubes, and ovary. Based on the