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Pregnancy Before Completion of Follow-Up in Gestational Trophoblastic Neoplasia: a Case Report

Document Type : Case Report

Authors

1 Department of Obstetrics and Gynecology, Fellowship of Gynecology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of of Radiotherapy, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 Fellowship of Gynecology Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Obstetrics and Gynecology, Fellowship of Gynecology Oncology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Introduction: Choriocarcinoma is a rare and malignant tumor, which may present during or following any type of pregnancy. This tumor often demonstrates rapid hematogenous spread to multiple organs and is associated with high levels of human chorionic gonadotropin (HCG) and a good response to chemotherapy. Herein, we introduced a case of metastatic choriocarcinoma who failed to response to conventional therapies.
Case presentation: A 22-year-old woman referred with vaginal bleeding. The evaluations revealed that she had a metastatic choriocarcinoma that failed to response to conventional therapies. Continuation of chemotherapy was not possible due to the development of neutropenia. Interestingly, the patient achieved a complete remission spontaneously without receiving further treatment. During the follow-up period, when the patient should not become pregnant, she became pregnant and had no problems during the pregnancy.
Conclusions: Gestational trophoblastic neoplasia is a rare disease. The majority of women suffering from this disease can be cured and their reproductive function could be preserved through the utilization of sensitive quantitation assay for human chorionic gonadotropin (β-hCG) and highly effective chemotherapy.

Keywords

References
1- Monchek R, Wiedaseck S. Gestational trophoblastic disease: An overview. J Midwifery Womens Health. 2012;57(3):255-9. doi: 10.1111/j.1542-2011.2012.00177.x. PubMed PMID: 22587615. ## 2-Berkowitz RS, Goldstein DP. Current advances in the management of gestational trophoblastic disease. Gynecol Oncol. 2013;128(1):3-5. doi: 10.1016/j.ygyno.2012.07.116. PubMed PMID: 22846466. ## 3-Oranratanaphan S, Lertkhachonsuk R. Treatment of extremely high risk and resistant gestational trophoblastic neoplasia patients in King Chulalongkorn Memorial Hospital. Asian Pac J Cancer Prev. 2014;15(2):925-8. doi: 10.7314/apjcp.2014.15.2.925. PubMed PMID: 24568520. ## 4.Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376(9742):717-29. doi: 10.1016/S0140-6736(10)60280-2. PubMed PMID: 20673583. 5-Manopunya M, Suprasert P. Resistant gestational tropho‌blastic neoplasia patients treated with 5 fluorouracil plus actinomycin D. Asian Pac J Cancer Prev. 2012;13(1):387-90. doi: 10.7314/apjcp.2012.13.1.387. PubMed PMID: 22502707. ## 6-FIGO Committee on Gynecologic Oncology. Current FIGO staging for cancer of the vagina, fallopian tube, ovary and gesta‌tional trophoblastic neoplasia. Int J Gynaecol Obstet. 2009;105(1):3-4. doi: 10.1016/j.ijgo.2008.12.015. PubMed PMID: 19322933. ## 7-Lurain JR. Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol. 2011;204(1):11-8. doi: 10.1016/j.ajog.2010.06.072. PubMed PMID: 20739008. ## 8-Kong Y, Yang J, Jiang F, Zhao J, Ren T, Li J, et al. Clinical characteristics and prognosis of ultra high-risk gestational trophoblastic neoplasia patients: a retrospective cohort study. Gynecol Oncol. 2017;146(1):81-86. doi: 10.1016/j.ygyno.2017.04.010. PubMed PMID: 28461032. ## 9-Williams J, Short D, Dayal L, Strickland S, Harvey R, Tin T, et al. Effect of early pregnancy following chemotherapy on disease relapse and fetal outcome in women treated for gestational trophoblastic neoplasia. J Reprod Med. 2014;59(5-6):248-54. PubMed PMID: 24937965. ## 10-Suzuka K, Matsui H, Iitsuka Y, Yamazawa K, Seki K, Sekiya S. Adjuvant hysterectomy in low-risk gestational trophoblastic disease. Obstet Gynecol. 2001;97(3):431-4. doi: 10.1016/s0029-7844(00)01169-8. PubMedPMID: 11239651. ## 11-Hanna RK, Soper JT. The role of surgery and radiation therapy in the management of gestational trophoblastic disease. Oncologist. 2010;15(6):593-600. doi: 10.1634/theoncologist.2010-0065. PubMed PMID: 20495216; PubMed Central PMCID: PMC3227996. ## 12-Bolis G, Bonazzi C, Landoni F, Mangili G, Vergadoro F, Zanaboni F, et al. EMA/CO regimen in high risk gestational trophoblastic tumor (GTT). Gynecol Oncol. 1988;31(3):439-44. doi: 10.1016/s0090-8258(88)80029-5. PubMed PMID: 2846414. ## 13-Horowitz NS, Elias KM, Goldstein D, Morrissey S, Collins SA, Childress J, et al. Compassionate use study of TRC105 (Endoglin Antibody) in combination with bevacizumab (Bev) in patients (pts) with refractory and metastatic choriocarcinoma. J Clin Oncol. 2016;34(15). doi: 10.1200/JCO.2016.34.15_suppl.e17033. ## 14-Niu G, Yuan LJ, Gong FQ, Yang J, Zhu CX, Shen HW. Early pregnancy following multidrug regimen chemotherapy in a gestational trophoblastic neoplasia patient: A case report. Medicine. 2017;96(51):e9221. doi: 10.1097/MD.0000000000009221. PubMed PMID: 29390471; PubMed Central PMCID: PMC5758173. ## 15-Huang M, Pinto A, Castillo RP, Slomovitz BM. Complete serologic response to pembrolizumab in a woman with chemoresistant metastatic choriocarcinoma. J Clin Oncol. 2017;35(27):3172-3174. doi: 10.1200/JCO.2017.74.4052. PubMed PMID: 28742453. ## 16-Kamata S, Sakurada A, Sato N, Noda M, Okada Y. A case of primary pulmonary choriocarcinoma successfully treated by surgery. Gen Thorac Cardiovasc Surg. 2017;65(6):361–364. doi: 10.1007/s11748-016-0666-8. PubMed PMID: 27236469. ##
Women’s Health Bulletin
Volume 8, Issue 3 - Serial Number 30
July 2021
Pages 189-194
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