High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy

Carlos Andres Trejos Ramirez; Juan Alejandro Gomez

doi:doi:10.11648/j.sjph.20221004.14

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High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy

Carlos Andres Trejos Ramirez, Juan Alejandro Gomez

Published in Science Journal of Public Health (Volume 10, Issue 4)

Received: 7 July 2022 Accepted: 29 July 2022 Published: 24 August 2022

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Abstract

Gestational trophoblastic disease covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue and leading to an irregular birth event. When this event occurs after surgery (eg, curettage) or evidence of metastatic disease arises, it is termed Gestational Trophoblastic Neoplasia and includes invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. In this context, it is a rare condition, with various forms of clinical presentation and with diagnostic alternatives that include imaging (transvaginal ultrasound, magnetic resonance imaging, and computed tomography), the measurement of hCG, which is useful for diagnosis and prognosis, and histology. Regarding treatment, it has been shown that if it is adequate and carried out by a multidisciplinary team, which involves polychemotherapy, radiotherapy and adjuvant surgery, it has a survival rate close to 70% if it is carried out early. This article reports an unusual case of a 32-year-old multipregnant woman who presented to the emergency department with abnormal uterine bleeding, an enlarged uterus, and hypovolemic shock after a full-term pregnancy with subsequent histological report of gestational trophoblastic disease and a catastrophic outcome due to distant metastases (brain and both lungs) and its complications.

Published in	Science Journal of Public Health (Volume 10, Issue 4)
DOI	10.11648/j.sjph.20221004.14
Page(s)	190-192
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Trophoblastic Gestational Disease, Choriocarcinoma, Brain Hemorrhage

References

[1]	Eysbouts YK, Ottevanger PB, Massuger LFAG, et al. Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia be simplified? A new retrospective analysis from a nationwide dataset. Ann Oncol. 2017; 28 (8): 1856–61.
[2]	Melamed A, Gockley AA, Joseph NT, et al. Effect of race/ethnicity on risk of complete and partial molar pregnancy after adjustment for age. Gynecol Oncol 2016; 143: 73.
[3]	Goldstein DP, Berkowitz RS. Current management of gestational trophoblastic neoplasia. Hematol Oncol Clin North Am 2012; 26: 111.
[4]	Li J, Yang J, Liu P, Ren T, Zhao J, Feng F, Wan X, Xiang Y. Clinical characteristics and prognosis of 272 postterm choriocarcinoma patients at Peking Union Medical College Hospital: a retrospective cohort study. BMC Cancer. 2016 Jun 2; 16: 347.
[5]	Maestá I, de Freitas Segalla Moreira M, Rezende-Filho J, et al. Outcomes in the management of high-risk gestational trophoblastic neoplasia in trophoblastic disease centers in South America. Int J Gynecol Cancer 2020; 30: 1366.
[6]	Ngan HYS, Seckl MJ, Berkowitz RS, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet 2018; 143 Suppl 2: 79.
[7]	Harvey RA, Mitchell HD, Stenman UH, et al. Differences in total human chorionic gonadotropin immunoassay analytical specificity and ability to measure human chorionic gonadotropin in gestational trophoblastic disease and germ cell tumors. J Reprod Med 2010; 55: 285.
[8]	Sharami SR, Saffarieh E. A review on management of gestational trophoblastic neoplasia. J Family Med Prim Care 2020; 9: 1287-95.
[9]	Kong Y, Yang J, Jiang F, et al. Clinical characteristics and prognosis of ultra high-risk gestational trophoblastic neoplasia patients: A retrospective cohort study. Gynecol Oncol 2017; 146: 81.
[10]	Lurain JR, Singh DK, Schink JC. Role of surgery in the management of high-risk gestational trophoblastic neoplasia. J Reprod Med 2006; 51: 773.
[11]	Lurain JR. Gestational trophoblastic disease II: classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol 2011; 204: 11.

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APA Style

Carlos Andres Trejos Ramirez, Juan Alejandro Gomez. (2022). High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Science Journal of Public Health, 10(4), 190-192. https://doi.org/10.11648/j.sjph.20221004.14

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ACS Style

Carlos Andres Trejos Ramirez; Juan Alejandro Gomez. High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Sci. J. Public Health 2022, 10(4), 190-192. doi: 10.11648/j.sjph.20221004.14

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AMA Style

Carlos Andres Trejos Ramirez, Juan Alejandro Gomez. High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Sci J Public Health. 2022;10(4):190-192. doi: 10.11648/j.sjph.20221004.14

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@article{10.11648/j.sjph.20221004.14,
  author = {Carlos Andres Trejos Ramirez and Juan Alejandro Gomez},
  title = {High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy},
  journal = {Science Journal of Public Health},
  volume = {10},
  number = {4},
  pages = {190-192},
  doi = {10.11648/j.sjph.20221004.14},
  url = {https://doi.org/10.11648/j.sjph.20221004.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221004.14},
  abstract = {Gestational trophoblastic disease covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue and leading to an irregular birth event. When this event occurs after surgery (eg, curettage) or evidence of metastatic disease arises, it is termed Gestational Trophoblastic Neoplasia and includes invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. In this context, it is a rare condition, with various forms of clinical presentation and with diagnostic alternatives that include imaging (transvaginal ultrasound, magnetic resonance imaging, and computed tomography), the measurement of hCG, which is useful for diagnosis and prognosis, and histology. Regarding treatment, it has been shown that if it is adequate and carried out by a multidisciplinary team, which involves polychemotherapy, radiotherapy and adjuvant surgery, it has a survival rate close to 70% if it is carried out early. This article reports an unusual case of a 32-year-old multipregnant woman who presented to the emergency department with abnormal uterine bleeding, an enlarged uterus, and hypovolemic shock after a full-term pregnancy with subsequent histological report of gestational trophoblastic disease and a catastrophic outcome due to distant metastases (brain and both lungs) and its complications.},
 year = {2022}
}

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TY  - JOUR
T1  - High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy
AU  - Carlos Andres Trejos Ramirez
AU  - Juan Alejandro Gomez
Y1  - 2022/08/24
PY  - 2022
N1  - https://doi.org/10.11648/j.sjph.20221004.14
DO  - 10.11648/j.sjph.20221004.14
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
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UR  - https://doi.org/10.11648/j.sjph.20221004.14
AB  - Gestational trophoblastic disease covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue and leading to an irregular birth event. When this event occurs after surgery (eg, curettage) or evidence of metastatic disease arises, it is termed Gestational Trophoblastic Neoplasia and includes invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. In this context, it is a rare condition, with various forms of clinical presentation and with diagnostic alternatives that include imaging (transvaginal ultrasound, magnetic resonance imaging, and computed tomography), the measurement of hCG, which is useful for diagnosis and prognosis, and histology. Regarding treatment, it has been shown that if it is adequate and carried out by a multidisciplinary team, which involves polychemotherapy, radiotherapy and adjuvant surgery, it has a survival rate close to 70% if it is carried out early. This article reports an unusual case of a 32-year-old multipregnant woman who presented to the emergency department with abnormal uterine bleeding, an enlarged uterus, and hypovolemic shock after a full-term pregnancy with subsequent histological report of gestational trophoblastic disease and a catastrophic outcome due to distant metastases (brain and both lungs) and its complications.
VL  - 10
IS  - 4
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Author Information

Carlos Andres Trejos Ramirez

Department of Ginecology, Tomas Uribe Uribe Hospital, Tulua, Colombia
Juan Alejandro Gomez

Department of Ginecology, Tomas Uribe Uribe Hospital, Tulua, Colombia

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Plain Text BibTeX RIS

APA Style

Carlos Andres Trejos Ramirez, Juan Alejandro Gomez. (2022). High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Science Journal of Public Health, 10(4), 190-192. https://doi.org/10.11648/j.sjph.20221004.14

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ACS Style

Carlos Andres Trejos Ramirez; Juan Alejandro Gomez. High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Sci. J. Public Health 2022, 10(4), 190-192. doi: 10.11648/j.sjph.20221004.14

Copy | Download

AMA Style

Carlos Andres Trejos Ramirez, Juan Alejandro Gomez. High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy. Sci J Public Health. 2022;10(4):190-192. doi: 10.11648/j.sjph.20221004.14

Copy | Download

@article{10.11648/j.sjph.20221004.14,
  author = {Carlos Andres Trejos Ramirez and Juan Alejandro Gomez},
  title = {High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy},
  journal = {Science Journal of Public Health},
  volume = {10},
  number = {4},
  pages = {190-192},
  doi = {10.11648/j.sjph.20221004.14},
  url = {https://doi.org/10.11648/j.sjph.20221004.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221004.14},
  abstract = {Gestational trophoblastic disease covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue and leading to an irregular birth event. When this event occurs after surgery (eg, curettage) or evidence of metastatic disease arises, it is termed Gestational Trophoblastic Neoplasia and includes invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. In this context, it is a rare condition, with various forms of clinical presentation and with diagnostic alternatives that include imaging (transvaginal ultrasound, magnetic resonance imaging, and computed tomography), the measurement of hCG, which is useful for diagnosis and prognosis, and histology. Regarding treatment, it has been shown that if it is adequate and carried out by a multidisciplinary team, which involves polychemotherapy, radiotherapy and adjuvant surgery, it has a survival rate close to 70% if it is carried out early. This article reports an unusual case of a 32-year-old multipregnant woman who presented to the emergency department with abnormal uterine bleeding, an enlarged uterus, and hypovolemic shock after a full-term pregnancy with subsequent histological report of gestational trophoblastic disease and a catastrophic outcome due to distant metastases (brain and both lungs) and its complications.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - High-Risk Gestational Trophoblastic Neoplasia with a Fatal Clinical Course After a Full-Term Pregnancy
AU  - Carlos Andres Trejos Ramirez
AU  - Juan Alejandro Gomez
Y1  - 2022/08/24
PY  - 2022
N1  - https://doi.org/10.11648/j.sjph.20221004.14
DO  - 10.11648/j.sjph.20221004.14
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 190
EP  - 192
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20221004.14
AB  - Gestational trophoblastic disease covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue and leading to an irregular birth event. When this event occurs after surgery (eg, curettage) or evidence of metastatic disease arises, it is termed Gestational Trophoblastic Neoplasia and includes invasive mole, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and choriocarcinoma. In this context, it is a rare condition, with various forms of clinical presentation and with diagnostic alternatives that include imaging (transvaginal ultrasound, magnetic resonance imaging, and computed tomography), the measurement of hCG, which is useful for diagnosis and prognosis, and histology. Regarding treatment, it has been shown that if it is adequate and carried out by a multidisciplinary team, which involves polychemotherapy, radiotherapy and adjuvant surgery, it has a survival rate close to 70% if it is carried out early. This article reports an unusual case of a 32-year-old multipregnant woman who presented to the emergency department with abnormal uterine bleeding, an enlarged uterus, and hypovolemic shock after a full-term pregnancy with subsequent histological report of gestational trophoblastic disease and a catastrophic outcome due to distant metastases (brain and both lungs) and its complications.
VL  - 10
IS  - 4
ER  -

Copy | Download