Flam F
Department of Woman and Child Health, Karolinska Hospital, Stockholm, Sweden.
Eur J Gynaecol Oncol. 1996;17(6):510-1.
Although choriocarcinoma following a term pregnancy is an uncommon disease, it is important to identify these patients early. The time interval between delivery and onset of treatment is a crucial factor influencing prognosis. We present a case where the woman was delivered of a stillborn infant and histological examination of the placenta at first did not reveal the true diagnosis of choriocarcinoma. Due to persistent vaginal bleeding curettage was performed 11 weeks later establishing choriocarcinoma. In this particular case it was then possible to review the original material and to confirm the diagnosis in this specimen. The case is extraordinary since the placenta harbouring the primary tumour had been macroscopically and microscopically described and the material could be reviewed. Secondly the case underlines the diagnostic difficulties when examining a mature placenta.
尽管足月妊娠后发生绒毛膜癌是一种罕见疾病,但早期识别这些患者很重要。分娩与开始治疗之间的时间间隔是影响预后的关键因素。我们报告一例病例,该妇女分娩出一名死产婴儿,最初对胎盘的组织学检查未揭示绒毛膜癌的真正诊断。由于持续阴道出血,11周后进行了刮宫术,确诊为绒毛膜癌。在这个特殊病例中,随后得以复查原始材料并在该标本中确诊。该病例不同寻常,因为含有原发性肿瘤的胎盘已在大体和显微镜下进行了描述,且材料可供复查。其次,该病例凸显了检查成熟胎盘时的诊断困难。