Chittenden Bradley, Ahamed Eliyaz, Maheshwari Abha
From the Obstetrics and Gynecology Department, Aberdeen Royal Infirmary, Aberdeen; Department of Medical Oncology, Charing Cross Hospital, London; and Assisted Reproduction Unit, University of Aberdeen, Aberdeen Maternity Hospital, Aberdeen, United Kingdom.
Obstet Gynecol. 2009 Aug;114(2 Pt 2):462-465. doi: 10.1097/AOG.0b013e3181aa97e7.
Choriocarcinoma typically occurs within 12 months of pregnancy but rarely may present many years after an antecedent pregnancy. This report describes choriocarcinoma in a postmenopausal woman.
A 62-year-old woman presented with dyspnea, a history of postmenopausal vaginal spotting, and metastatic disease on chest X-ray. A transvaginal ultrasonogram revealed a thickened endometrium. Endometrial biopsy and an elevated beta-hCG confirmed the diagnosis of metastatic choriocarcinoma. Multiagent chemotherapy was initiated, and the patient developed fatal toxic epidermal necrolysis.
This case reminds practitioners that choriocarcinoma can occur in postmenopausal women, and although cure rates are high, deaths occasionally occur because of toxicity associated with treatment.
绒毛膜癌通常发生在妊娠后12个月内，但很少在既往妊娠多年后出现。本报告描述了一名绝经后妇女的绒毛膜癌病例。
一名62岁女性出现呼吸困难，有绝经后阴道点滴出血史，胸部X线检查发现转移性疾病。经阴道超声检查显示子宫内膜增厚。子宫内膜活检及β-hCG升高确诊为转移性绒毛膜癌。开始进行多药化疗，患者发生致命的中毒性表皮坏死松解症。
该病例提醒临床医生，绒毛膜癌可发生于绝经后妇女，尽管治愈率较高，但偶尔会因治疗相关毒性而导致死亡。
