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Vaginal Growth of Choriocarcinoma Managed by Emergent Embolization: Review and Case Report

Abstract

Purpose

Embolization of arterial supply of tumor and pelvic metastatic tissue has been widely used as an elective modality as an adjunct to chemotherapy in the management of gynecological tumors. It can be a rescue life-saving procedure in heavily pouring masses and also treatment modality so as to reduce the size of mass by endovascular methods. This is specifically remarkable in cases where other measures of hemorrhage control fail or are inapplicable.

Method

Here we report the case of 27-year-old lady with vaginal metastasis of choriocarcinoma with uncontrollable bleeding that was managed by emergent embolization.

Results

Coil embolization of bilateral internal iliac arteries by transfemoral route was done to control bleeding from vaginal metastatic growth of choriocarcinoma, which was in close proximity to urethral orifice. Emergent embolization proved to be a successful rescue modality of bleeding control from vaginal metastatic lesion of choriocarcinoma.

Discussion

Embolization has an emergent and elective role of in the management of choriocarcinoma. Intervention radiology is of immense importance not only in regular elective cases, it also can be used as an emergent measure. If the process is expedited, and the avoidable delays are somehow overcome, it can be used for emergent control of gynecological hemorrhage.

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References

  1. 1.

    Savage J, Adams E, Veras E, Murphy KM, Ronnett BM. Choriocarcinoma in women: analysis of a case series with genotyping. Am J Surg Pathol. 2017;41(12):1593–606.

    Article  Google Scholar 

  2. 2.

    Meng C, et al. Internal iliac artery balloon occlusion for placenta previa and suspected placenta accreta a randomized controlled trial. Obstet Gynecol. 2020;135:1112–9.

    Article  Google Scholar 

  3. 3.

    Keung JJ, Spies BJ, Caridi TM. Uterine artery embolization: a review of current concepts. Best Pract Res Clin Obstet Gynaecol. 2018;46:66–73.

    Article  Google Scholar 

  4. 4.

    Chupin AV, Deriabin SV, Chigasov VA. Embolizatsiia vnutrennel podvzdoshnoi arterii pri endoprotezirovaniianevrizmy briushnoi aorty [Embolization of theinternal iliac artery during endovascular repair of abdominal aortic aneurysms]. Angiol Sosud Khir. 2019;25(4):76–82. https://doi.org/10.33529/ANGIO2019417.

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Wang J, Shi X, Li Y, Li Z, Chen Y, Zhou J. Prophylactic intraoperative uterine or internal iliac artery embolization in planned cesarean for pernicious placenta previa in the third trimester of pregnancy. Medicine. 2019. https://doi.org/10.1097/MD.0000000000017767.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Gregorio MAD, et al. Pelvic venous disorders in women due to pelvic varices: treatment by embolization: experience in 520 patients. J Vascul Interv Radiol. 2020;31(10):1560–9.

    Article  Google Scholar 

  7. 7.

    Bonde A, et al. Bilateral internal iliac artery embolization for pelvic trauma: effectiveness and safety. Am J Surg. 2020;220(2):454–8.

    Article  Google Scholar 

Download references

Acknowledgements

I would like to acknowledge the efforts of Dr. Gauri Gandhi, who played a vital role in expediting the whole process, and consultant cardiothoracic vascular surgeon (Dr. N.T.) for skillful support.

Funding

This procedure was carried out in a government institution. No additional funding requirements were there.

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Correspondence to Swati Priya.

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Conflict of interest

There is no potential conflict of interest.

Informed Consent

Proper written informed consent was taken prior to embolization.

Human and Animal Rights

This does not involve research on animals.

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Priya, S., Gandhi, G. Vaginal Growth of Choriocarcinoma Managed by Emergent Embolization: Review and Case Report. Indian J Gynecol Oncolog 19, 95 (2021). https://doi.org/10.1007/s40944-021-00591-z

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Keywords

  • Choriocarcinoma
  • Vagina
  • Uterus
  • Hemorrhage
  • Embolization