title: Gestational trophoblastic neoplasia with retroperitoneal metastases: a fatal complication.
abstract: BACKGROUND
  Gestational Trophoblastic Neoplasia (GTN) is a pathologic entity that can affect any pregnancy and develop long after the termination of the pregnancy. Its course can be complicated by metastases to distant sites such as the lung, brain, liver, kidney and vagina. The therapeutic approach of this condition includes both surgical intervention and chemotherapy. The prognosis depends on many prognostic factors that determine the stage of the disease.
  
  
  METHODS
  We present a woman with GTN and retroperitoneal metastatic disease who came to our department and was diagnosed as having high risk metastatic GTN. Accordingly she received chemotherapy as primary treatment but unfortunately developed massive bleeding after the first course of chemotherapy, was operated in an attempt to control bleeding but finally succumbed.
  
  
  CONCLUSIONS
  This case demonstrates that GTN, while usually curable, can be a deadly disease requiring improved diagnostic, treatment modalities and chemotherapeutic agents. The gynaecologist should be aware of all possible metastatic sites of GTN and the patient immediately referred to a specialist center for further assessment and treatment.
authors.affiliation: Department of Clinical and Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Belitsos
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Ioannis
authors.initials: I
authors.lastname: Chatzinikolaou
authors.forename: Athanassios-Meletios
authors.initials: AM
authors.lastname: Dimopoulos
authors.forename: Christos A
authors.initials: CA
authors.lastname: Papadimitriou
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012186:Retroperitoneal Neoplasms / Q000139:chemically induced / Q000188:drug therapy / Q000556:secondary*
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin