Following metastatic placental site trophoblastic tumor with urine beta-core fragment.
OBJECTIVE
We document a case with metastatic placental site trophoblastic tumor in a 47-year-old postmenopausal women.


METHODS
beta-core fragment was measured in urine using the Triton UGP kit. hCG was also measured using the Bayer Immuno-1hCG assay (at Memorial Sloan-Kettering Cancer Center).


RESULTS
Over 2 years the patient underwent two courses of chemotherapy and two debulking operations. During this time, hCG levels decreased from 227 to 4.1 mIU/ml. hCG levels were close to the limit of detection (<3 mIU/ml), indicating complete or near-complete regression of disease. At this point urine beta-core fragment levels were determined. High levels were detected 7.9 fmol/ml, consistent with the continued existence of tumor (>1.9 fmol/ml). High-dose chemotherapy (CEM) was started with stem cell harvesting. In the following weeks hCG levels failed to identify the tumor (4.1 to <3 mIU/ml). In the first week (during therapy) beta-core fragment levels increased (12 fmol/ml), and in the following weeks (after therapy) levels regressed to 1.2 fmol/ml.


CONCLUSIONS
Urine beta-core fragment may be a useful tumor maker when serum hCG levels are near to or below the limit of detection.
Department of Obstetrics and Gynecology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA.
K
K
Rinne
S
S
Shahabi
L
L
Cole
D014408:Biomarkers, Tumor / Q000652:urine*; D006063:Chorionic Gonadotropin / Q000652:urine*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000652:urine*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000652:urine*; D010446:Peptide Fragments / Q000652:urine*; D018245:Trophoblastic Tumor, Placental Site / Q000556:secondary* / Q000652:urine*; D014594:Uterine Neoplasms / Q000652:urine*
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; C063554:urinary gonadotropin fragment