Gestational trophoblastic tumor after medical abortion.
BACKGROUND
Nonmetastatic gestational trophoblastic tumor occurring after early elective medical abortion using mifepristone and misoprostol is unusual.


METHODS
A young woman at 6 to 7 weeks' gestation presented with brown spotting requesting medical abortion. Pretreatment ultrasound was consistent with an abnormal pregnancy. Passage of tissue ensued after mifepristone-misoprostol administration. Recovery was normal, with a postabortion ultrasound on day 16 showing a reduction in intracavitary contents. The patient declined surveillance with serial beta-human chorionic gonadotropin (beta-hCG) levels and was lost to follow-up. Sixty days after initial treatment, she presented to a hospital with a history of intermittent bleeding and underwent curettage, revealing a complete hydatidiform mole. Chemotherapy was instituted when levels of hCG plateaued. Complete hCG regression occurred after three weekly injections of methotrexate, and postmolar surveillance is uneventful to date.


CONCLUSIONS
Gestational trophoblastic tumor may occur after early medical abortion.
Lichtenberg
E Steve
ES
The Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA. fpamg@cais.com
D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects*; D000032:Abortion, Therapeutic / Q000009:adverse effects* / Q000379:methods; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D015735:Mifepristone / Q000009:adverse effects*; D016595:Misoprostol / Q000009:adverse effects*; D010120:Oxytocics / Q000009:adverse effects*; D011247:Pregnancy; D011261:Pregnancy Trimester, First
D000021:Abortifacient Agents, Steroidal; D000970:Antineoplastic Agents; D010120:Oxytocics; D016595:Misoprostol; D015735:Mifepristone; D008727:Methotrexate