[Clinical analysis of 13 cases of gestational trophoblastic tumor misdiagnosed as ectopic pregnancy].
OBJECTIVE
To evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy.


METHODS
From 1999 to 2003, a total of 13 patients with GTT misdiagnosed as ectopic pregnancy were retrospectively analyzed.


RESULTS
The main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding. Serum beta-human chorionic gonadotrop in (hCG) was measured in 10 patients. Eight had hCG values above 10,000 IU/L; 3 had hCG values above 50,000 IU/L. The lesions of GTT misdiagnosed as ectopic pregnancy were fallopian tube, horn of uterus, peritoneal cavity, greater omentum, recto-uterine pouch. According to standards of the International Federation of Gynecology and Obstetrics (FIGO) the 13 patients were categorized as 6 of stage I, 2 of stage II, 3 of stage III and 5 of stage IV. Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole. All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy.


CONCLUSIONS
Misdiagnosis leads to delay in therapy with resultant increased morbidity of GTT. Analysis on serial hCG is helpful to differential diagnosis between ectopic pregnancy and GTT.
Qian
Jian-hua
JH
Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Ye
Da-fen
DF
Xie
Xing
X
D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002822:Choriocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D003951:Diagnostic Errors; D004334:Drug Administration Schedule; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D002820:Hydatidiform Mole, Invasive / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging / Q000592:standards; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D003609:Dactinomycin; D003520:Cyclophosphamide; D008727:Methotrexate