Abstract
In December 1992 a 27-year-old primagravida woman had a baby girl by normal vaginal delivery. The third trimester of pregnancy was complicated by mild pre-eclamsia which settled after delivery. Five weeks later the patient experienced vaginal bleeding which persisted intermittently until she attended hospital 3 months post partum when a urinary hCG pregnancy test was negative and a pelvic ultra-sound scan showed a thickened uterine wall. The bleeding continued but she did not represent until she had a heavy vaginal bleed 8 months post partum. She felt pregnant, with malaise and nausea, and her urinary pregnancy test was positive. A uterine dilatation and curettage was undertaken and the histology revealed choriocarcinoma.
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References
World Health Organisation Scientific Group. Gestational trophoblastic diseases. In Technical Report Series No. 692. Geneva: WHO 1983.
Newlands ES, Bagshawe KD, Begent RHJ et al. Results with the EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regime in high risk gestational trophoblastic tumours, 1979 to 1989. Br J Obstet Gynaecol 1991; 98:550–7.
Bagshawe KD, Harland S. Immunodiagnosis and monitoring of gonadotrophin-producing metastases in the central nervous system. Cancer 1976; 38:112–8.
Begent R. Radioimmunolocalization of germ cell tumours. In Jones WG, Milford Ward A, Anderson CK (eds): Germ Cell Tumours II. Oxford: Pergamon Press 1986; 159–62.
Baltazar JC. Epidemiological features of choriocarcinoma. Bull WHO 1976; 54:523.
Bagshawe KD. Risk and prognostic factors in trophoblastic neoplasia. Cancer 1976; 38:1373–85.
Fisher RA, Lawler SD, Povey S et al. Genetically homozygous choriocarcinoma following pregnancy with hydatidiform mole. Br J Cancer 1988; 58:788–92.
Bagshawe KD, Lawler SD, Paradinas FJ et al. Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform mole. Lancet 1990; 335:1074–6.
Wake N, Tanaka K-I, Chapman V et al. Chromosomes and cellular origin of choriocarcinoma. Cancer Res 1981; 41:3137–43.
Chaganti RSK, Kodura PRK, Chakraborty R et al. Genetic origin of a trophoblastic choriocarcinoma. Cancer Res 1990; 50:6330–33.
Osada H, Kawata M, Yamada M et al. Genetic identification of pregnancies responsible for choriocarcinomas after multiple pregnancies by restriction fragmant length polymorphism analysis. Am J Obstet Gynecol 1991; 165:682–8.
Fisher RA, Newlands ES, Jeffreys AJ et al. Gestational and non-gestational trophoblastic tumours distinguished by DNA analysis. Cancer 1992; 69:839–45.
Suzuki T, Goto S, Nawa A et al. Identification of the pregnancy responsible for gestational trophoblastic disease by DNA analysis. Obstet Gynecol 1993; 82:629–34.
Fisher RA, Soteriou B, Meredith L et al. Previous hydatidiform mole identified as the causative pregnancy of choriocarcinoma following birth of normal twins. Int J Gynecol Cancer 1995; 5:64–70.
Sheppard DM, Fisher RA, Lawler SD. Karyotypic analysis and chromosome polymorphisms in four choriocarcinoma cell lines. Cancer Genet Cytogenet 1985; 16:251–9.
O’Reilly SM, Rustin GJS. Mismanagement of choriocarcinoma due to a false low HCG measurement. Int J Gynecol Cancer 1993; 3:186–8.
Giralt SA, Dexeus F, Amato R et al. Hyperthyroidism in men with germ cell tumors and high levels of beta-human chorionic gonadotrophin. Cancer 1992; 69:1286–90.
Searle F, Boden J, Lewis JCM et al. A human choriocarcinoma xenograft in nude mice; a model for the study of antibody localization. Br J Cancer 1981; 44:137–44.
Steller MA, Mok SC-H, Yeh et al. Effects of cytokines on epidermal growth factor receptor expression by malignant trophoblast cells in vitro. J Reprod Med 1994; 39:209–16.
Rustin GJS, Newlands ES, Begent RHJ et al. Weekly alternating etoposide, methotrexate and actinomycin/vincristine and cyclophosphamide for the treatment of CNS metastases of choriocarcinoma. J Clin Oncol 1989; 7:900–3.
Lotz J-P, André T, Donsimoni R et al. High dose chemotherapy with ifosfamide, carboplatin and etoposide combined with autologous bone marrow transplantation for the treatment of poor-prognosis germ cell tumors and metastatic trophoblastic disease in adults. Cancer 1995; 75:874–85.
Wenzel LB, Berkowitz RS, Robinson S et al. Psychological, social and sexual effects of gestational trophoblastic disease on patients and their partners. J Reprod Med 1994; 39:163–7.
Rustin GJS, Booth M, Dent J et al. Pregnancy after cytotoxic chemotherapy gestational trophoblastic tumours. Br Med J 1984; 288:103–6.
Newlands ES, Rustin GJS, Holden L et al. Incidence of second tumours in patients treated with cytotoxic chemotherapy for gestational trophoblastic tumours (GTT) at Charing Cross Hospital 1958-1990. Proc VII World Congress on Gestational Trophoblastic Diseases, Hong Kong 1994.
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© 1997 Springer Science+Business Media Dordrecht
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Bower, M., Brock, C., Fisher, R.A., Newlands, E.S., Rustin, G.J.S. (1997). Gestational choriocarcinoma. In: Souhami, R.L. (eds) The Teaching Cases from Annals of Oncology. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5456-7_21
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DOI: https://doi.org/10.1007/978-94-011-5456-7_21
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