Gestational Trophoblastic Neoplasia with Brain Metastasis Presented with Initial Presentation of Dyspnea: A Case Report
عنوان مقاله: Gestational Trophoblastic Neoplasia with Brain Metastasis Presented with Initial Presentation of Dyspnea: A Case Report
شناسه ملی مقاله: JR_JOGCR-6-1_007
منتشر شده در در سال 1399
شناسه ملی مقاله: JR_JOGCR-6-1_007
منتشر شده در در سال 1399
مشخصات نویسندگان مقاله:
Haleh Ayatollahi - Department of Obstetrics and Gynecology, School of Medicine, Solid Tumor Research Center, Research Institute on Cellular and Molecular Medicine, Shahid Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Samira Jahangard - Department of Obstetrics and Gynecology, School of Medicine, Solid Tumor Research Center, Research Institute on Cellular and Molecular Medicine, Shahid Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
خلاصه مقاله:
Haleh Ayatollahi - Department of Obstetrics and Gynecology, School of Medicine, Solid Tumor Research Center, Research Institute on Cellular and Molecular Medicine, Shahid Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Samira Jahangard - Department of Obstetrics and Gynecology, School of Medicine, Solid Tumor Research Center, Research Institute on Cellular and Molecular Medicine, Shahid Motahari Hospital, Urmia University of Medical Sciences, Urmia, Iran
Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is ۱۱%. In this paper, we reported a case of choriocarcinoma with brain metastasis, which was successfully treated with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen.
Case presentation: A ۳۴-year-old woman was presented with vaginal bleeding, dyspnea, and moderate abdominal pain. She had a menstrual delay of about two weeks. She had a primary β-human chorionic gonadotropin (β-hCG) of ۱۳۲ ۶۰۰ mIU/mL. On lung computed tomography (CT) scan images, a metastatic lesion with a size of ۶۸×۵۰ mm was observed in the lower lobe of the left lung. The patient underwent dilation and curettage (D&C) that revealed choriocarcinoma. Brain magnetic resonance imaging (MRI) also showed a small metastatic mass with a size of ۷ mm at the right occipital lobe. The patient was started on chemotherapy with an EMACO regimen. The patient’s β-hCG decreased continuously, and it was negative after the fourth cycle and six sessions of radiotherapy. It also remained negative six months after chemotherapy. The final examinations of the patient had no abnormal findings.
Conclusion: Brain metastasis may be relatively asymptomatic in patients with choriocarcinoma, and it should be considered by physicians, even when there are no neurological symptoms. Also, the EMACO regimen seems to be an appropriate regimen for the treatment of metastatic choriocarcinoma.
کلمات کلیدی: Gestational trophoblastic neoplasm, Metastasis, Pleural effusion, Dyspnea
صفحه اختصاصی مقاله و دریافت فایل کامل: https://civilica.com/doc/1154166/