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因诊断延误导致的晚期绒毛膜癌所致孕产妇及新生儿死亡:一例病例报告

Maternal and neonatal death from advanced choriocarcinoma due to a delay in diagnosis: a case report.

作者信息

Parks D Gene

机构信息

Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, USA.

出版信息

J Reprod Med. 2007 Mar;52(3):228-30.

PMID:17465293
Abstract

BACKGROUND

Metastatic choriocarcinoma rarely coexists with a normal pregnancy.

CASE

A 36-year-old multipara presented to the hospital at 23 weeks' gestation with progressive dyspnea and tachycardia. She was admitted and evaluated by the Psychiatry Department for presumed panic disorder and had perinatology, pulmonary, cardiology and infectious disease consultations. Over the course of 5 days she developed respiratory failure, delivered a nonviable infant and died from complications of metastatic pulmonary choriocarcinoma. Choriocarcinoma was not considered in the differential diagnosis of the respiratory failure until the day prior to the patient's death.

CONCLUSION

Choriocarcinoma, although rare, should be considered in the differential diagnosis of pregnant women presenting with abnormally elevated serum beta-human chorionic gonadotropin levels and respiratory failure.

摘要

背景

转移性绒毛膜癌很少与正常妊娠并存。

病例

一名36岁经产妇在妊娠23周时因进行性呼吸困难和心动过速入院。她因疑似惊恐障碍入住精神科,并接受了围产医学、肺部、心脏和传染病方面的会诊。在5天的病程中,她出现呼吸衰竭,产下一个无法存活的婴儿,最终死于转移性肺绒毛膜癌并发症。直到患者死亡前一天,呼吸衰竭的鉴别诊断中才考虑到绒毛膜癌。

结论

对于血清β-人绒毛膜促性腺激素水平异常升高并伴有呼吸衰竭的孕妇,鉴别诊断时应考虑绒毛膜癌,尽管其较为罕见。

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