[Lung metastasis after pelviscopic salpingectomy in therapy of tubal pregnancy].
A 34-year old VI gravida, II para underwent a pelviscopic salpingectomy of the left fallopian tube for treatment of a repeated ectopic pregnancy. Histology revealed an invasive hydatidiform mole. The declining beta-hCG titers after surgery were not further controlled. Seven months later a secondary amenorrhoea occurred again; beta-hCG levels increased steadily. We could not obtain trophoblastic tissue by operative pelvis-copy (excision of the tubal stump on the left side and tubal sterilisation on the right side) nor by curettage of the uterine cave. A lesion of the lung was interpreted as a metastatic lesion following malignant transformation of the invasive hydatidiform mole and disappeared under cytotoxic therapy containing methotrexate with an uneventful follow-up period of now 4 years.


CONCLUSIONS
In order not to overlook the presence of persistent trophoblastic tissue and the possible development of a choriocarcinoma, beta-hCG serum titers should be measured until they disappear, following the surgical therapy of an ectopic pregnancy.
Bonatz
G
G
Universitätsfrauenklinik Kiel.
Kunstmann
P
P
Jänig
U
U
Quirin
A
A
Semm
K
K
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000601:surgery*; D010535:Laparoscopy; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments