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绒毛膜癌和上皮滋养细胞肿瘤:子宫切除术联合外周血干细胞支持下的大剂量化疗成功治疗复发:一例报告

Choriocarcinoma and epithelial trophoblastic tumor: successful treatment of relapse with hysterectomy and high-dose chemotherapy with peripheral stem cell support: a case report.

作者信息

Knox Stacey, Brooks Sandra E, Wong-You-Cheong Jade, Ioffe Olga, Meisenberg Barry, Goldstein Donald Peter

机构信息

Department of Obstetrics and Gynecology and Reproductive Sciences, School of Medicine, Baltimore, Maryland 21201, USA.

出版信息

Gynecol Oncol. 2002 Apr;85(1):204-8. doi: 10.1006/gyno.2002.6583.

Abstract

BACKGROUND

Post-termchoriocarcinoma is a rare complication of pregnancy. The presence of epithelioid trophoblastic elements may lead to the persistence of locally invasive disease which is unresponsive to multiagent chemotherapy. Relapse is associated with an estimated mortality rate of 30%.

CASE

We present a case of Stage IC post-term choriocarcinoma and epithelioid trophoblastic tumor. While the metastatic sites in the lungs responded to multiagent chemotherapy, a hysterectomy was required to treat persistent disease in the uterus. The patient relapsed within 4 months of completion of chemotherapy. Relapse was treated with high-dose chemotherapy with peripheral stem cell support. The patient is alive with no evidence of disease 23 months posttransplant.

CONCLUSIONS

The application of multimodality treatment and high-dose chemotherapy resulted in a successful outcome for this patient, indicating a potential role for high-dose therapy in patients who suffer a relapse of choriocarcinoma.

摘要

背景

过期妊娠性绒毛膜癌是一种罕见的妊娠并发症。上皮样滋养层细胞成分的存在可能导致局部侵袭性疾病持续存在,对多药化疗无反应。复发的估计死亡率为30%。

病例

我们报告一例IC期过期妊娠性绒毛膜癌和上皮样滋养层细胞瘤病例。虽然肺部转移灶对多药化疗有反应,但需要行子宫切除术来治疗子宫内的持续性疾病。患者在化疗结束后4个月内复发。复发采用高剂量化疗并辅以外周干细胞支持进行治疗。移植后23个月,患者存活且无疾病证据。

结论

多模式治疗和高剂量化疗的应用使该患者获得了成功的治疗结果,表明高剂量治疗在绒毛膜癌复发患者中具有潜在作用。

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