Pan Yongmiao, Lin Kaiqing, Hu Ying, Song Xiaohong, Xu Linjun, Zhou Zhenfeng, Xie Di, Xue Yuan
Department of Obstetrics and Gynecology, Hangzhou Women's Hospital, Hangzhou, China.
Department of Obstetrics and Gynecology, Hangzhou Red Cross Hospital, Hangzhou, China.
Gynecol Minim Invasive Ther. 2024 Jul 18;13(3):184-188. doi: 10.4103/gmit.gmit_86_23. eCollection 2024 Jul-Sep.
Invasive hydatidiform mole, a form of gestational trophoblastic neoplasm in reproductive-age women, poses a significant threat to life due to its associated signs and symptoms. This case report details the management of a 24-year-old Chinese woman with no prior pregnancy history, who presented at our hospital 23 days postcurettage, experiencing persistent vaginal bleeding for 3 days. While two rounds of chemotherapy effectively reduced human chorionic gonadotropin levels, a subsequent magnetic resonance imaging (MRI) revealed suspicious growth lesions in the uterus. High-intensity focused ultrasound (HIFU) treatment was administered under ultrasound guidance, resulting in notable grayscale changes to optimize the efficacy of chemotherapy and restrict lesion progression. Subsequent ultrasound and MRI assessments during follow-up demonstrated a transparent texture in the muscle layer at the lesion site. This case suggests that the combination of chemotherapy and HIFU, guided by ultrasound, may represent a promising therapeutic approach for managing invasive hydatidiform mole.
侵袭性葡萄胎是育龄期妇女妊娠滋养细胞肿瘤的一种形式，因其相关的体征和症状对生命构成重大威胁。本病例报告详细介绍了一名24岁、无既往妊娠史的中国女性的治疗情况，她在刮宫术后23天到我院就诊，持续阴道出血3天。虽然两轮化疗有效降低了人绒毛膜促性腺激素水平，但随后的磁共振成像（MRI）显示子宫内有可疑的生长性病变。在超声引导下进行了高强度聚焦超声（HIFU）治疗，导致显著的灰度变化，以优化化疗效果并限制病变进展。后续随访期间的超声和MRI评估显示病变部位肌层质地透明。该病例表明，在超声引导下，化疗与HIFU联合应用可能是治疗侵袭性葡萄胎的一种有前景的治疗方法。
