Cheng Xiao-Dong, Lü Wei-Guo, Wan Xiao-Yun, Chen Xiao-Duan, Xie Xing
Department of Oncological, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Apr;43(4):281-5.
To evaluate the clinical characteristics of epithelioid trophoblastic tumor (ETT).
Six cases of ETT treated in Women's Hospital, School of Medicine, Zhejiang University from 2005 to 2007 were retrospectively analyzed, together with a literature review.
Six cases of ETT were diagnosed pathologically after surgery. The age of patients ranged from 27 to 46 years. The most common presentation was abnormal vaginal bleeding (5/6). The preceding gestational events were hydatidiform mole in 1 case, abortion in 2 cases, and term delivery in 3 cases. The interval between the preceding gestation and the diagnosis of ETT ranged from 15-48 months. The serum human chorionic gonadotropin (hCG) level was 46-121.47 IU/L. Four cases presented with metastasis, including lung metastasis in all of the 4 cases, liver metastasis in 1 case, and pancreas metastasis in another 1 case. The main therapies were surgery combined with chemotherapy. All of the 6 cases received total abdominal hysterectomy, and 1 case also had lung lobectomy. One case had a recurrence but refused any treatment again, and was lost to follow up; the therapy of 1 case unfinished; another 4 cases were without evidence of disease 9 to 19 months after surgery.
The confirmation of ETT diagnosis is difficult before surgery. Surgical management is mostly recommended in ETT. The role of chemotherapy in ETT is not clear yet.
评估上皮样滋养细胞肿瘤(ETT)的临床特征。
回顾性分析2005年至2007年在浙江大学医学院附属妇产科医院治疗的6例ETT患者,并进行文献复习。
6例ETT患者均经手术后病理确诊。患者年龄27~46岁。最常见的表现为阴道不规则出血(5/6)。既往妊娠史:葡萄胎1例,流产2例,足月产3例。既往妊娠至ETT诊断的间隔时间为15~48个月。血清人绒毛膜促性腺激素(hCG)水平为46~121.47 IU/L。4例出现转移,其中4例均有肺转移,1例有肝转移,另1例有胰腺转移。主要治疗方法为手术联合化疗。6例均行全子宫切除术,1例行肺叶切除术。1例复发后拒绝再次治疗,失访;1例治疗未完成;另4例术后9~19个月无疾病证据。
ETT术前诊断困难。ETT大多推荐手术治疗。化疗在ETT中的作用尚不清楚。