title: Ultrasound-guided local injection of methotrexate to treat an invasive hydatidiform mole.
abstract: A 28-year-old Japanese woman had an invasive hydatidiform mole which was diagnosed by means of transvaginal ultrasonography. After the two initial courses of systemic methotrexate (MTX) therapy given over a period of weeks, the tumor was 14 mm in diameter and the surrounding blood supply remained rich. In addition to the two initial courses of systemic MTX therapy, local ultrasound-guided injection of MTX therapy was given three times, once per week. After the local MTX treatment, the betahCG level, which had been as high as 240 ng/mL, dropped to less than 0.1 ng/mL. We then gave two additional courses of systemic MTX therapy (once per week). More than 3 years have passed since the final systemic MTX therapy, and the patient's serum betahCG levels continue to be less than 0.1 ng/mL. An invasive mole can be treated with an ultrasound-guided local injection of MTX in addition to the established systemic MTX treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Tottori University, School of Medicine, Tottori, Japan. tsuki@grape.med.tottori-u.ac.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsukihara
authors.forename: Tasuku
authors.initials: T
authors.lastname: Harada
authors.forename: Naoki
authors.initials: N
authors.lastname: Terakawa
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D020073:Gravidity; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D015552:Injections, Intralesional; D008727:Methotrexate / Q000008:administration & dosage*; D009361:Neoplasm Invasiveness; D011247:Pregnancy; D018084:Ultrasonography, Interventional; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate