Blackwell Conner, McLeish Shian, Iglesias David, Armbruster Shannon D
Department of Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
Case Rep Obstet Gynecol. 2023 Feb 8;2023:1901858. doi: 10.1155/2023/1901858. eCollection 2023.
Persistent elevation in beta-human chorionic gonadotropin (-hCG) following a pregnancy is concerning for gestational trophoblastic neoplasia (GTN). However, the differential diagnosis should remain broad during the evaluation process.
A 34-year-old G3P3 presented with elevated -hCG four months after cesarean delivery with bilateral tubal ligation. The patient was treated with methotrexate for a presumed new ectopic pregnancy. Due to persistent -hCG elevation, she received actinomycin-D for GTN treatment. After completing chemotherapy, her -hCG increased. The patient underwent a laparoscopic hysterectomy with unplanned left oophorectomy due to its nodular appearance at the time of surgery. Pathology confirmed a dysgerminoma of the ovary and benign uterus.
Although dysgerminomas are uncommon, they should be considered when -hCG levels remain elevated despite therapies for more common pathologies.
妊娠后β-人绒毛膜促性腺激素（β-hCG）持续升高提示妊娠滋养细胞肿瘤（GTN）。然而，在评估过程中鉴别诊断范围应保持宽泛。
一名34岁经产妇（G3P3），剖宫产及双侧输卵管结扎术后4个月出现β-hCG升高。患者因推测为新的异位妊娠接受甲氨蝶呤治疗。由于β-hCG持续升高，她接受放线菌素-D治疗GTN。化疗结束后，她的β-hCG升高。患者接受了腹腔镜子宫切除术，术中因左侧卵巢呈结节状外观而意外切除左侧卵巢。病理证实为卵巢无性细胞瘤和子宫良性病变。
尽管无性细胞瘤并不常见，但当针对更常见病因进行治疗后β-hCG水平仍持续升高时，应考虑该病。
