Lok C A R, Reekers J A, Westermann A M, Van der Velden J
Department of Obstetrics and Gynaecology, H4-Zuid, Academic Medical Center, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
Gynecol Oncol. 2005 Sep;98(3):506-9. doi: 10.1016/j.ygyno.2005.04.029.
Because gestational trophoblastic disease (GTD) is highly sensitive to chemotherapy, life-threatening hemorrhage from metastases can occur especially early after starting therapy.
Two cases of post-term choriocarcinoma with liver metastases complicated by profuse life-threatening hemorrhage are reported. Emergency treatment with transcatheter angiographic embolization of the hepatic artery was performed to control bleeding.
Although embolization of the iliac vessels for gynecologic malignancies, including GTD, have been described, this is the first time that embolization of the hepatic artery to control bleeding from liver metastases in GTD is reported. The use and indications for embolization are expanding, and also in acute hemorrhagic complications in GTD, this intervention should be considered.
由于妊娠滋养细胞疾病(GTD)对化疗高度敏感,尤其是在开始治疗后早期,转移灶可能会发生危及生命的出血。
报告了2例足月绒癌伴肝转移并伴有大量危及生命出血的病例。采用经导管肝动脉造影栓塞术进行紧急治疗以控制出血。
尽管已有文献描述了包括GTD在内的妇科恶性肿瘤的髂血管栓塞术,但这是首次报道通过肝动脉栓塞术控制GTD肝转移出血。栓塞术的应用和适应证正在不断扩展,在GTD的急性出血并发症中,也应考虑这种干预措施。