Ollendorff D A, Goldberg J M, Abu-Jawdeh G M, Lurain J R
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois.
Obstet Gynecol. 1990 Sep;76(3 Pt 2):494-7.
Determination of maternal serum alpha-fetoprotein (MSAFP) has become an important screening test for a variety of fetal and maternal abnormalities. A 33-year-old multiparous white woman had a markedly elevated MSAFP level (140 multiples of the median). Extensive antepartum work-up for fetal anomalies, fetal-maternal transfusion, or maternal etiology revealed no explanation. The patient subsequently delivered a healthy male infant. Pathologic examination of the placenta demonstrated a small, discrete area of choriocarcinoma. Computed tomography showed a solitary pulmonary metastasis. Because the patient did not desire future pregnancies, a total abdominal hysterectomy was performed, followed by four courses of EMA-CO chemotherapy. Her serum hCG levels subsequently became undetectable. Choriocarcinoma of the placenta must be considered in the differential diagnosis of an otherwise unexplained elevated MSAFP level.
测定母血清甲胎蛋白（MSAFP）已成为针对多种胎儿和母体异常情况的一项重要筛查试验。一名33岁经产白人女性的MSAFP水平显著升高（为中位数的140倍）。对胎儿异常、胎儿-母体输血或母体病因进行的广泛产前检查未发现任何解释。该患者随后分娩出一名健康男婴。胎盘的病理检查显示有一个小的、孤立的绒毛膜癌区域。计算机断层扫描显示有一个孤立的肺转移灶。由于该患者不打算未来再怀孕，遂进行了全腹子宫切除术，随后接受了四个疗程的EMA-CO化疗。她的血清hCG水平随后变得无法检测到。在鉴别诊断MSAFP水平升高但原因不明的情况时，必须考虑胎盘绒毛膜癌。
