Choriocarcinoma and epithelial trophoblastic tumor: successful treatment of relapse with hysterectomy and high-dose chemotherapy with peripheral stem cell support: a case report.
BACKGROUND
Post-termchoriocarcinoma is a rare complication of pregnancy. The presence of epithelioid trophoblastic elements may lead to the persistence of locally invasive disease which is unresponsive to multiagent chemotherapy. Relapse is associated with an estimated mortality rate of 30%.


METHODS
We present a case of Stage IC post-term choriocarcinoma and epithelioid trophoblastic tumor. While the metastatic sites in the lungs responded to multiagent chemotherapy, a hysterectomy was required to treat persistent disease in the uterus. The patient relapsed within 4 months of completion of chemotherapy. Relapse was treated with high-dose chemotherapy with peripheral stem cell support. The patient is alive with no evidence of disease 23 months posttransplant.


CONCLUSIONS
The application of multimodality treatment and high-dose chemotherapy resulted in a successful outcome for this patient, indicating a potential role for high-dose therapy in patients who suffer a relapse of choriocarcinoma.
Knox
Stacey
S
Department of Obstetrics and Gynecology and Reproductive Sciences, School of Medicine, Baltimore, Maryland 21201, USA.
Brooks
Sandra E
SE
Wong-You-Cheong
Jade
J
Ioffe
Olga
O
Meisenberg
Barry
B
Goldstein
Donald Peter
DP
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002822:Choriocarcinoma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007044:Hysterectomy; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage
D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate