Luk Wan Yu, Friedlander Michael
Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia.
Case Rep Obstet Gynecol. 2013;2013:492754. doi: 10.1155/2013/492754. Epub 2013 May 2.
Background. Gestational trophoblastic disease (GTD) is a rare complication of pregnancy which is characterised by abnormal growth of the trophoblasts at the placental site. It is categorised into benign and malignant forms, which include hydatidiform moles (HMs) and gestational trophoblastic neoplasia (GTN), respectively. A mixed choriocarcinoma (CC) and epithelioid trophoblastic tumour (ETT) is an extremely rare subgroup of GTN, which is a highly curable but aggressive form of malignancy. Case. We report a case of mixed CC and ETT in a 41-year-old patient who presented with a 2-year history of menorrhagia and fibroid uterus in the absence of previous history of molar pregnancy. She had a 12-year interval between the antecedent pregnancy and presentation. She was treated with intensive regimen of adjuvant chemotherapy, etoposide, methotrexate, and actinomycin-D with etoposide and cisplatin (EMA-EP). She has remained disease free for more than 5 years. Conclusion. This case highlights the importance of considering GTN as one of the differential diagnoses value of β -HCG in patients presented with menorrhagia and growing fibroids.
背景。妊娠滋养细胞疾病（GTD）是一种罕见的妊娠并发症，其特征是胎盘部位的滋养细胞异常生长。它分为良性和恶性形式，分别包括葡萄胎（HM）和妊娠滋养细胞肿瘤（GTN）。绒毛膜癌（CC）和上皮样滋养细胞肿瘤（ETT）混合型是GTN中极为罕见的一个亚组，GTN是一种虽高度可治愈但具有侵袭性的恶性肿瘤形式。病例。我们报告一例41岁患者的CC和ETT混合型病例，该患者有2年月经过多及子宫肌瘤病史，既往无葡萄胎妊娠史。此次发病距上次妊娠有12年间隔。她接受了依托泊苷、甲氨蝶呤、放线菌素-D联合依托泊苷和顺铂的强化辅助化疗方案（EMA-EP）治疗。她已无病生存超过5年。结论。该病例突出了在月经过多和肌瘤增大的患者中将GTN作为β-HCG鉴别诊断之一的重要性。
