Black Kristin A, Simone Kristen, Hirt-Walsh Cassandra, Sabourin Jeanelle
Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Grey Nuns Community Hospital, Edmonton, Alberta, Canada.
Gynecol Oncol Rep. 2021 Jan 30;36:100715. doi: 10.1016/j.gore.2021.100715. eCollection 2021 May.
Epithelioid trophoblastic tumor is a rare form of gestational trophoblastic neoplasia. We present the first known case of this rare malignancy presenting as a Caesarean scar defect.
A patient with 3 prior Caesarean sections presented with vaginal bleeding 2 months following management of retained products of conception. Her hCG was negative. She underwent surgical repair of a Caesarean scar defect, and pathology was consistent with epithelioid trophoblastic tumor.
This case highlights the possibility of malignancy presenting to the general gynecologist as a Caesarean scar defect. The diagnosis of gestational trophoblastic neoplasia should always be considered in the differential diagnosis of a patient with postpartum vaginal bleeding. Limited evidence on fertility conserving treatment of epithelioid trophoblastic tumors does not seem favorable.
上皮样滋养细胞肿瘤是妊娠滋养细胞肿瘤的一种罕见形式。我们报告了首例已知的以剖宫产瘢痕缺损形式出现的这种罕见恶性肿瘤病例。
一名有3次剖宫产史的患者,在处理残留妊娠物2个月后出现阴道出血。她的人绒毛膜促性腺激素(hCG)呈阴性。她接受了剖宫产瘢痕缺损的手术修复,病理结果与上皮样滋养细胞肿瘤一致。
该病例凸显了恶性肿瘤以剖宫产瘢痕缺损形式出现在普通妇科医生面前的可能性。对于产后阴道出血的患者进行鉴别诊断时,应始终考虑妊娠滋养细胞肿瘤的诊断。关于上皮样滋养细胞肿瘤保留生育功能治疗的证据有限,似乎并不乐观。