Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, 1-2 Mitsuzawa Nishimachi Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan.
Department of Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, 1-2 Mitsuzawa Nishimachi Kanagawa-ku, Yokohama, Kanagawa, 221-0855, Japan.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):708-712. doi: 10.1016/j.tjog.2021.09.036.
To report the rare case of gestational primary ovarian choriocarcinoma coexistent with intrauterine pregnancy, successfully treated with surgery and systemic chemotherapy. We also describe the utility of short tandem repeat (STR) genotyping in the diagnosis of choriocarcinoma.
A 38-year-old woman at 17 gestational weeks presented with an ovarian tumor rupture in the left ovary. Left salpingo-oophorectomy was performed and the patient was diagnosed with gestational ovarian choriocarcinoma via histopathology and STR genotyping. After artificial abortion, the patient underwent 8 cycles of chemotherapy. Abdominal hysterectomy was performed because of the presence of low levels of human chorionic gonadotropin and the tumor that developed behind the uterus. However, no viable choriocarcinoma cells were found in the residual tumor, suggesting that the patient achieved full remission.
Early detection is crucial in treating choriocarcinomas; thus, clinicians should consider the possibility of choriocarcinoma at the presence of an ovarian tumor during pregnancy. Gestational and non-gestational choriocarcinomas differ in prognosis and sensitivity to chemotherapy due to their different etiologies. Therefore, STR genotyping may be beneficial in predicting the patient's prognosis or selecting the appropriate regimen.
报道一例罕见的妊娠合并宫内妊娠原发性卵巢绒毛膜癌，经手术和全身化疗成功治疗。我们还描述了短串联重复（STR）基因分型在绒毛膜癌诊断中的应用。
一名 38 岁女性，妊娠 17 周，左侧卵巢肿瘤破裂。行左侧输卵管卵巢切除术，组织病理学和 STR 基因分型诊断为妊娠性卵巢绒毛膜癌。人工流产后，患者接受了 8 个周期的化疗。由于人绒毛膜促性腺激素水平低和子宫后方的肿瘤，行腹式全子宫切除术。然而，在残留肿瘤中未发现有活力的绒毛膜癌细胞，提示患者达到完全缓解。
早期发现对于治疗绒毛膜癌至关重要；因此，临床医生在妊娠期间存在卵巢肿瘤时应考虑绒毛膜癌的可能性。妊娠性和非妊娠性绒毛膜癌由于病因不同，在预后和对化疗的敏感性方面存在差异。因此，STR 基因分型可能有助于预测患者的预后或选择合适的治疗方案。
