A case of metastasizing invasive hydatidiform mole. Is less--less good? Review of the literature with regard to adequate treatment.

Abstract:

BACKGROUND:Patients with invasive hydatidiform moles (IHM) have a good prognosis. Even if disease has spread, monocytostatic treatment might be sufficient if the diagnosis has been histologically confirmed. Established classifications divide gestational trophoblastic disease (GTD) including choriocarcinoma into cases with "high" and "low" risk. Without respect to histology "high-risk" cases are recommended to obtain polychemotherapy. CASE:A 40-year-old nullipara underwent hysterectomy for persistent vaginal bleeding after she had already been treated with curettage for hydatidiform mole. An IHM was pathohistologically confirmed. There were no signs of pulmonary spread or other metastases at the time of surgery. Postsurgically persistent beta-hCG levels lead to thorough staging, which revealed multiple pulmonary metastases and a vaginal metastasis. Despite metastasizing GTD with poor prognosis criteria she was treated with single agent therapy. Eight cycles of two weekly methotrexate (MTX) were administered. All sites of metastases responded and our patient is still fine after one year of follow-up. CONCLUSION:With respect to this and other reports monochemotherapy can be a reasonable primary treatment for metastatic IHM.

journal_name

Eur J Gynaecol Oncol

authors

Honig A,Rieger L,Kristen P,Eck M,Frambach T,Tschammler A,Caffier H,Dietl J

keywords:

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

158-62

issue

2

eissn

0392-2936

issn

2709-0086

journal_volume

26

pub_type

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