Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
BMC Womens Health. 2019 Jul 23;19(1):101. doi: 10.1186/s12905-019-0794-2.
A persistent low-level elevation of serum human chorionic gonadotropin (hCG) without clinical or radiological evidence of pregnancy or tumors was recently defined as quiescent gestational trophoblastic disease (Q-GTD). Whether patients with Q-GTD should be treated or allowed to become pregnant remains unclear. We herein report a rare case of Q-GTD in which the hCG level spontaneously returned to normal after a successful pregnancy.
The patient was a 37-year-old primigravida who presented with a persistent low-level elevation of hCG after uterine evacuation of a hydatidiform mole. There was no evidence of neoplasia in the uterus or distant metastasis. The low-level elevation of hCG persisted for at least 2 years but never exceeded 200 mIU/mL. The patient had a successful pregnancy at the age of 40 years.
Interestingly, her hCG level subsequently normalized without chemotherapy. The present case may imply the safety and therapeutic effect of pregnancy in women with Q-GTD.
最近,血清人绒毛膜促性腺激素(hCG)水平持续低水平升高而无妊娠或肿瘤的临床或影像学证据被定义为静止性妊娠滋养细胞疾病(Q-GTD)。目前尚不清楚是否应该治疗或允许 Q-GTD 患者怀孕。本文报告了一例罕见的 Q-GTD 病例,hCG 水平在成功妊娠后自发恢复正常。
患者为 37 岁初产妇,葡萄胎清宫术后 hCG 持续低水平升高。子宫或远处无肿瘤转移证据。hCG 低水平升高至少持续了 2 年,但从未超过 200 mIU/ml。患者 40 岁时成功妊娠。
有趣的是,她的 hCG 水平随后在未经化疗的情况下恢复正常。本病例可能意味着妊娠对 Q-GTD 患者是安全且有效的。