Unusual presentation of a metastatic choriocarcinoma following a full term pregnancy: a case report.
Choriocarcinoma most commonly follows a molar pregnancy, but it may develop after any gestational event. If choriocarcinoma follows a term pregnancy, it is associated with an unfavorable outcome and a 60% survival rate. A 33 year female who had delivered a normal girl 4 months before, presented with a nodule on the scalp behind the right ear. The pathologic diagnosis was compatible with metastatic choriocarcinoma. This tumor did not respond to chemotherapy, and she died a year later of multiple liver and pulmonary metastases. The development of a choriocarcinoma following a full term pregnancy is associated with a poor prognosis. We suggest that patients who do not achieve a clinical or serological remission after EMA-CO treatment be considered for high dose chemotherapy such as transplant.
Balat
O
O
Department of Gynecology Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, USA.
Verschraegen
C F
CF
Edwards
C L
CL
Silva
E
E
Kudelka
A P
AP
Kavanagh
J J
JJ
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy; D002822:Choriocarcinoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000473:pathology*; D014750:Vincristine / Q000008:administration & dosage
D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate