Gauchez Anne-Sophie, Dreux Sophie, Stéfani Laetitia, Mousseau Mireille, Jouk Pierre-Simon, Muller Françoise
Prenat Diagn. 2007 Jul;27(7):682-4. doi: 10.1002/pd.1769.
The incidence of ovarian malignancies during gestation ranges from 1 in 8000 to 1 in 20,000 deliveries. Ovarian malignancies that produce human chorionic gonadotropin (hCG) are limited to germ cell tumors, of which dysgerminoma is the most frequent (45%) malignant type encountered in pregnant patients, the others being ovarian choriocarcinoma and mixed germ cell tumors (Boulay and Podczaski, 1998). In women of childbearing age, it is hard to distinguish between metastatic choriocarcinoma on a complete mole and primary ovarian choriocarcinoma. Treatment is based on adnexectomy followed by chemotherapy. Given the extreme rarity of these tumors, the long-term prognosis is difficult to establish. Had the diagnosis for our patient been made during pregnancy, the therapeutic approach would have been discussed in terms of gestational age. In the last trimester, we could have suggested cesarean section followed by adnexectomy, and then chemotherapy. In the second-trimester, chemotherapy could have been discussed, although the fetal toxicity of cisplatin chemotherapy is not firmly defined (Ferrandina et al., 2005). This treatment is an alternative to termination of pregnancy. We retrospectively studied maternal serum biochemistry so as to assess the possibility of a diagnosis of ovarian choriocarcinoma at the time of maternal serum screening for Down syndrome.
妊娠期卵巢恶性肿瘤的发病率在每8000至20000次分娩中有1例。产生人绒毛膜促性腺激素（hCG）的卵巢恶性肿瘤仅限于生殖细胞肿瘤，其中无性细胞瘤是妊娠患者中最常见的恶性类型（45%），其他为卵巢绒毛膜癌和混合性生殖细胞肿瘤（Boulay和Podczaski，1998年）。在育龄妇女中，完全性葡萄胎转移性绒毛膜癌与原发性卵巢绒毛膜癌很难区分。治疗方法是先进行附件切除术，然后进行化疗。鉴于这些肿瘤极为罕见，很难确定其长期预后。如果在患者孕期做出诊断，治疗方案会根据孕周进行讨论。在妊娠晚期，我们可能会建议剖宫产，随后进行附件切除术，然后化疗。在妊娠中期，可以讨论化疗，尽管顺铂化疗对胎儿的毒性尚不明确（Ferrandina等人，2005年）。这种治疗方法是终止妊娠的一种替代方案。我们回顾性研究了孕妇血清生化指标，以评估在唐氏综合征孕妇血清筛查时诊断卵巢绒毛膜癌的可能性。
