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输卵管绒毛膜癌表现为破裂的异位妊娠:病例报告及文献复习。

Tubal choriocarcinoma presented as ruptured ectopic pregnancy: a case report and review of the literature.

机构信息

Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, 100# Haining Rd, Shanghai, 200080, China.

出版信息

World J Surg Oncol. 2020 Sep 12;18(1):245. doi: 10.1186/s12957-020-02021-4.

Abstract

BACKGROUND

Tubal choriocarcinoma is an extremely rare but highly malignant trophoblastic tumor, which may be either gestational or non-gestational in origin. Due to atypical clinical manifestations and symptoms similar to ectopic pregnancy, it is easily to be confused with ectopic pregnancy. In addition, inadequate understanding of this rare disease by clinicians often leads to misdiagnosis or missed diagnosis, which in turn results in delayed treatment or even tumor metastasis.

CASE PRESENTATION

This report summarized a case of a woman who was finally diagnosed as tubal choriocarcinoma through the follow-up of serum β hCG levels and histopathological results after undergoing salpingectomy for being misdiagnosed as ectopic pregnancy. Five courses of adjuvant chemotherapy (5-fluorouracil, actinomycin-D, vinorelbine regime) have been administered to the patient in the prevention of any recurrences. During 1-year follow-up, the patient was asymptomatic and presented no evidence of recurrence.

CONCLUSIONS

Tubal choriocarcinoma is easily to be confused with ectopic pregnancy. By analyzing this case and previous related cases, we aimed to provide references for clinicians in the diagnosis and treatment of tubal choriocarcinoma.

摘要

背景

输卵管绒毛膜癌是一种极其罕见但高度恶性的滋养细胞肿瘤,可能源于妊娠或非妊娠。由于其临床表现不典型,症状类似于异位妊娠,因此容易与异位妊娠混淆。此外,临床医生对这种罕见疾病的认识不足,常常导致误诊或漏诊,进而导致治疗延误甚至肿瘤转移。

病例介绍

本报告总结了 1 例患者,该患者因误诊为异位妊娠而行输卵管切除术,随后通过随访血清β hCG 水平和组织病理学结果最终诊断为输卵管绒毛膜癌。为预防复发,患者接受了 5 个疗程的辅助化疗(氟尿嘧啶、放线菌素 D、长春瑞滨方案)。在 1 年的随访中,患者无症状,无复发迹象。

结论

输卵管绒毛膜癌容易与异位妊娠混淆。通过分析本病例及以往相关病例,旨在为临床医生诊断和治疗输卵管绒毛膜癌提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74bd/7488679/cf722f6fcab6/12957_2020_2021_Fig1_HTML.jpg

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