IMR Press / EJGO / Volume 27 / Issue 1 / pii/2006106

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research

Intraplacental choriocarcinoma metastasizing to the maternal lung

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1 Department of Neonatology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
2 Institute of Pathology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
3 Unit of Feta-Maternal Medicine, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
4 Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eur. J. Gynaecol. Oncol. 2006, 27(1), 29–32;
Published: 10 February 2006
Abstract

Background: Although normal pregnancy is the precursor of 25% of cases of maternal choriocarcinoma, intraplacental chorio­carcinoma in an otherwise normal placenta associated with viable pregnancy has rarely been reported. Case: Examination of the placenta after delivery of a pale and small-for-date infant at term revealed intraplacental choriocarc1noma. There was no evidence of metastatic disease in the mother or child, but the mother exhibited postpartum rising levels of beta­HCG. The mother refused chemotherapy and disappeared from follow-up. Nine months later, she presented with metastatic chori­ocarcinoma of the Jung. Eleven courses of the multi-drug EMA CO regimen effected a decrease of beta-HCG to normal and disappearance of lung metastases. To date, 28 months after the end of chemotherapy, the patient is alive and without evidence of gestational trophoblastic disease. Moreover, since then she has given birth to an additional two children. Conclusions: This case is an example of natural disease progression of intraplacental choriocarcinoma metastasizing to the mother. Furthermore, it supports common knowledge that the multi-drug EMA CO regimen is effective treatment in poor prognosis metastatic choriocarcinoma.

Keywords
Placenta
Choriocarcinoma
Trophobiast
Chemotherapy
EMA CO regimen
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