Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
BMC Cancer. 2017 Dec 20;17(1):876. doi: 10.1186/s12885-017-3904-2.
Invasive mole derives from hydatidiform mole, but its pathogenesis remains unknown. Invasive mole arising from iatrogenic uterine perforation has not been reported yet.
A reproductive woman was admitted because she suffered form severe abdominal pain and acute intra-abdominal hemorrhage after suction evacuation due to misdiagnosis as inevitable abortion. The patient underwent hysteroscopy and laparoscopy, by which an iatrogenic uterine perforation and omentum and pelvic peritoneum metastases were confirmed. All lesions were removed and the final pathological diagnosis was metastatic invasive mole. The patient underwent post-operative chemotherapy with methotrexate and presented a good prognosis.
Invasive mole arising form iatrogenic uterine perforation displays an unusual metastatic manner other than general invasive moles. The prevention of uterine perforation should be emphasized during suction evacuation for mole pregnancy.
侵袭性葡萄胎源自葡萄胎,但发病机制尚不清楚。医源性子宫穿孔引起的侵袭性葡萄胎尚未见报道。
一名生育期妇女因误诊难免流产而行吸宫术,术后出现剧烈腹痛和急性腹腔内出血而入院。患者行宫腔镜和腹腔镜检查,确诊为医源性子宫穿孔和大网膜及盆腔腹膜转移。所有病灶均被切除,最终病理诊断为转移性侵袭性葡萄胎。患者术后接受甲氨蝶呤化疗,预后良好。
医源性子宫穿孔引起的侵袭性葡萄胎表现出一种不同寻常的转移方式,与一般的侵袭性葡萄胎不同。在葡萄胎妊娠吸宫术时应强调预防子宫穿孔。