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一例罕见的妊娠性绒毛膜癌伴肺和阴道转移及梗阻性黄疸病例。

A Rare Case of Gestational Choriocarcinoma with Lung and Vaginal Metastases with Obstructive Jaundice.

作者信息

Gupta Shivani, Jhirwal Manisha, Sharma Charu, Shekhar Shashank

机构信息

Department of Obstetrics and Gynecology, AIIMS Jodhpur, Flat no. 902, Darshan Tower, Zalim Villas, Paota B Road, Jodhpur, Rajasthan 342001 India.

出版信息

J Obstet Gynaecol India. 2022 Jun;72(3):262-264. doi: 10.1007/s13224-021-01490-1. Epub 2021 Jun 26.

Abstract

Choriocarcinoma is a rare highly malignant neoplasm which may present with early metastases as it has a propensity of rapid haematogenous spread. However the neoplasm is chemosensitive and has a good prognosis even in advanced stages. We are presenting a case of a 26 years old female with early pregnancy presented with lung and vaginal metastases with obstructive jaundice. [International Federation of Gynaecology and Obstetrics (FIGO) stage III; World Health Organization score, 14]. Serum beta-hCG was 3,61,131 mIU/ml. Radiological evaluation suggested marked lung metastases with vaginal metastases. Patient was started on single agent chemotherapy doxorubicin in view of deranged liver function test. Patient was given 5 cycles of doxorubicin with liver function test and beta hcg monitoring. After liver function test normalized, patient was shifted to EMACO regimen for 6 cycles of treatment dose and 2 cycles of maintenance dose.

摘要

绒毛膜癌是一种罕见的高度恶性肿瘤,因其有迅速血行播散的倾向,可能早期就出现转移。然而,该肿瘤对化疗敏感,即使在晚期预后也较好。我们报告一例26岁早孕女性,出现肺和阴道转移并伴有梗阻性黄疸。(国际妇产科联合会(FIGO)分期为III期;世界卫生组织评分14分)。血清β-人绒毛膜促性腺激素(β-hCG)为361131mIU/ml。影像学评估提示有明显的肺转移和阴道转移。鉴于肝功能检查异常,患者开始接受单药化疗多柔比星治疗。患者接受了5个周期的多柔比星治疗,并监测肝功能和β-hCG。肝功能检查恢复正常后,患者转用EMA-CO方案进行6个周期的治疗剂量和2个周期的维持剂量治疗。

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