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.
Rinne
K
K
Department of Obstetrics and Gynecology, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut, 06520, USA.
Shahabi
S
S
Cole
L
L
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