采用腹腔镜宫角造口术及术后甲氨蝶呤注射成功治疗子宫角部妊娠滋养细胞肿瘤。

Successful treatment of gestational trophoblastic neoplasia in the uterine cornus with laparoscopic cornuostomy and postoperative methotrexate injection.

作者信息

Chen Pei-Ling, Jhuang Jie-Yang, Lin Ho-Hsiung, Hsiao Sheng-Mou

机构信息

Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Department of Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2017 Apr;56(2):261-263. doi: 10.1016/j.tjog.2016.09.008.

DOI:10.1016/j.tjog.2016.09.008

PMID:28420522

Abstract

OBJECTIVE

Management of cornual gestational trophoblastic neoplasia (GTN) has never been reported. Here, we describe the first case of cornual GTN.

CASE REPORT

A 32-year-old woman was diagnosed with left cornual GTN after evacuation of a complete mole. Laparoscopic cornuostomy was performed with intramural vasopression injection and barbed sutures. Histopathology revealed hydropic chorionic villi. Complete hydatidiform mole was diagnosed, and treated with adjuvant methotrexate, to address the poor decline of β-human chorionic gonadotropin levels during follow-up. The β- human chorionic gonadotropin levels declined to < 1 mIU/mL 9 months after cornuostomy. She successfully conceived 16 months after cornuostomy, and underwent cesarean section at 37 gestational weeks due to concomitant severe preeclampsia.

CONCLUSION

Cornual GTN can be successfully managed with laparoscopic cornuostomy and adjuvant methotrexate.

摘要

目的

宫角部妊娠滋养细胞肿瘤（GTN）的治疗此前从未有过报道。在此，我们描述首例宫角部GTN病例。

病例报告

一名32岁女性在完全性葡萄胎清宫术后被诊断为左侧宫角部GTN。行腹腔镜宫角造口术，术中进行壁内血管加压注射并使用倒刺缝线。组织病理学检查显示绒毛水肿。诊断为完全性葡萄胎，并采用甲氨蝶呤辅助治疗，以解决随访期间β-人绒毛膜促性腺激素水平下降不佳的问题。宫角造口术后9个月，β-人绒毛膜促性腺激素水平降至<1 mIU/mL。她在宫角造口术后16个月成功受孕，因并发严重子痫前期，于孕37周行剖宫产。