Maeda Yuto, Oyama Ruriko, Maeda Hirona, Imai Yukihiro, Yoshioka Shinya
Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan.
Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan.
J Obstet Gynaecol Res. 2018 Aug;44(8):1476-1481. doi: 10.1111/jog.13677. Epub 2018 May 29.
Gestational trophoblastic neoplasm (GTN) is a serious morbidity of complete hydatidiform mole with coexistent fetus (CHMCF) and usually develops after termination of pregnancy. Here we report a case of choriocarcinoma derived from CHMCF during pregnancy. A 33-year-old multiparous woman with suspected CHMCF was admitted with a severe cough. Computed tomography revealed multiple lung metastases. Cesarean section and hysterectomy were performed at 31 weeks of gestation on diagnosis of high-risk GTN from International Federation of Gynecology and Obstetrics (FIGO) scoring. A live female infant weighing 1390 g was delivered. Choriocarcinoma was diagnosed from pathological findings. The patient received multi-agent chemotherapy and was discharged on the 40th postoperative day. In conclusion, CHMCF can result in high-risk GTN during pregnancy. For a suspected GTN, diagnosis from FIGO scoring should determine treatment strategy. If patients with CHMCF wish to continue their pregnancy, careful follow-up, including regular chest radiography and ultrasonography, is warranted.
妊娠滋养细胞肿瘤（GTN）是伴有共存胎儿的完全性葡萄胎（CHMCF）的一种严重并发症，通常在妊娠终止后发生。在此，我们报告一例妊娠期间源自CHMCF的绒毛膜癌病例。一名33岁有多次分娩史的妇女，因疑似CHMCF并伴有严重咳嗽入院。计算机断层扫描显示肺部有多处转移灶。在妊娠31周时，根据国际妇产科联盟（FIGO）评分诊断为高危GTN后，进行了剖宫产和子宫切除术。产下一名体重1390克的活女婴。病理检查结果确诊为绒毛膜癌。患者接受了多药联合化疗，术后第40天出院。总之，CHMCF可导致妊娠期间发生高危GTN。对于疑似GTN，根据FIGO评分进行诊断应能确定治疗策略。如果CHMCF患者希望继续妊娠，则有必要进行仔细的随访，包括定期胸部X线检查和超声检查。
