Couder F, Golfier F, Vaudoyer F, Massardier J, Guastalla J-P, Hajri T, Raudrant D
Centre français de référence des maladies trophoblastiques, université Lyon-1, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
Gynecol Obstet Fertil. 2012 Jun;40(6):376-8. doi: 10.1016/j.gyobfe.2012.02.006. Epub 2012 Apr 20.
Chemotherapy is the reference treatment for gestational trophoblastic neoplasia. In case of chemoresistance, hysterectomy has to be considered even in women wishing to conceive. A 31-year-old nulliparous patient presented a recurrent invasive mole, despite two regimens of chemotherapy. She underwent a partial uterine resection of an intramyometrial choriocarcinoma followed by a third-line regimen. Two years later she gave birth by cesarean section at 32 weeks of amenorrhea to a healthy child after a spontaneous pregnancy. In order to preserve patient's fertility, conservative uterine surgery is an alternative to hysterectomy for selected chemoresistant gestational trophoblastic neoplasia.
化疗是妊娠滋养细胞肿瘤的标准治疗方法。对于化疗耐药的情况,即使是希望怀孕的女性也必须考虑行子宫切除术。一名31岁未生育的患者,尽管接受了两种化疗方案,但仍出现复发性侵袭性葡萄胎。她接受了子宫肌层内绒毛膜癌的部分子宫切除术,随后接受了三线化疗方案。两年后,她在停经32周时通过剖宫产分娩了一个健康的婴儿,此次妊娠为自然受孕。为了保留患者的生育能力,对于某些化疗耐药的妊娠滋养细胞肿瘤患者,保守性子宫手术可替代子宫切除术。