Generic placeholder image

New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Case Report

Diagnostic and Management Challenges of Rapid Lung Metastasis of Gestational Trophoblastic Neoplasia after a Non-molar Pregnancy: A Case Report

Author(s): Trilok Chand*, Norbert Dreier, Urfan Ul Haq, Fady Hachem and Vikram Kumar

Volume 4, Issue 1, 2023

Published on: 03 May, 2023

Article ID: e080323214481 Pages: 6

DOI: 10.2174/04666230308144244

open_access

Abstract

:Background: Pulmonary metastasis of pregnancy-related rare gestational trophoblastic disease is common, and a patient’s rapid clinical deterioration leads to a poor prognosis.

Case Presentation: We report a case of a non-pregnant woman with severe respiratory symptoms masquerading as pulmonary infection who was diagnosed with pulmonary metastasis of the gestational trophoblastic disease.

Conclusion: The timely diagnosis of pulmonary metastasis was the key aspect in the management of our case, and she survived and was discharged to home after a long hospitalization course.

Keywords: Gestational trophoblastic neoplasia, Hydatidiform mole, Choriocarcinoma, Pulmonary metastasis, Pleural debris, Pneumothorax, betahCG, Chemotherapy.

[1]
Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol 2010; 203(6): 531-9.
[http://dx.doi.org/10.1016/j.ajog.2010.06.073] [PMID: 20728069]
[2]
Newlands ES, Bagshawe KD, Begent RHJ, Rustin GJS, Holden L. Results with the EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) regimen in high risk gestational trophoblastic tumours, 1979 to 1989. BJOG 1991; 98(6): 550-7.
[http://dx.doi.org/10.1111/j.1471-0528.1991.tb10369.x] [PMID: 1651757]
[3]
Berkowitz RS, Goldstein DP. Current advances in the management of gestational trophoblastic disease. Gynecol Oncol 2013; 128(1): 3-5.
[http://dx.doi.org/10.1016/j.ygyno.2012.07.116] [PMID: 22846466]
[4]
Harsono AB, Hidayat YM, Winarno GNA, Nisa AS, Alkaff FF. A case of rapid transformation from hydatidiform mole to invasive mole: The importance of β-hCG (Human Chorionic Gonadotropin) serum levels in follow-up evaluation. Am J Case Rep 2021; 22: e931156.
[http://dx.doi.org/10.12659/AJCR.931156] [PMID: 34127641]
[5]
Martínez LC, García VJ, García-Foncillas LJ, Idrovo F, Plaza AJ, Albi GM. Invasive mole in a perimenopausal woman with lung and vaginal metastases: A case report. Clin Case Rep 2019; 7(12): 2300-5.
[http://dx.doi.org/10.1002/ccr3.2386] [PMID: 31893046]
[6]
Berkowitz RS, Goldstein DP. Current management of gestational trophoblastic diseases. Gynecol Oncol 2009; 112(3): 654-62.
[http://dx.doi.org/10.1016/j.ygyno.2008.09.005] [PMID: 18851873]
[7]
Mangili G, Lorusso D, Brown J, et al. Trophoblastic disease review for diagnosis and management: A joint report from the international society for the study of trophoblastic disease, european organisation for the treatment of trophoblastic disease, and the gynecologic cancer intergroup. Int J Gynecol Cancer 2014; 24(9): S109-16.
[http://dx.doi.org/10.1097/IGC.0000000000000294] [PMID: 25341573]
[8]
Strohl AE, Lurain JR. Clinical epidemiology of gestational trophoblastic disease. Curr Obstet Gynecol Rep 2014; 3(1): 40-3.
[http://dx.doi.org/10.1007/s13669-013-0070-7]
[9]
Gvinianidze L, Panagiotopoulos N, Woo WL, Borg E, Lawrence D. The challenging management of lung choriocarcinoma. J Thorac Dis 2014; 6(10): E220-2.
[PMID: 25364535]
[10]
FIGO Committee on Gynecologic Oncology. Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet 2009; 105(1): 3-4.
[http://dx.doi.org/10.1016/j.ijgo.2008.12.015] [PMID: 19322933]
[11]
Altieri A, Franceschi S, Ferlay J, Smith J, Vecchia CL. Epidemiology and aetiology of gestational trophoblastic diseases. Lancet Oncol 2003; 4(11): 670-8.
[http://dx.doi.org/10.1016/S1470-2045(03)01245-2] [PMID: 14602247]
[12]
Ngan HYS, Seckl MJ, Berkowitz RS, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet 2018; 143(S2): 79-85.
[http://dx.doi.org/10.1002/ijgo.12615] [PMID: 30306586]
[13]
Lurain JR. Gestational trophoblastic disease II: Classification and management of gestational trophoblastic neoplasia. Am J Obstet Gynecol 2011; 204(1): 11-8.
[http://dx.doi.org/10.1016/j.ajog.2010.06.072] [PMID: 20739008]
[14]
Braga A, Mora P, Melo AC, et al. Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide. World J Clin Oncol 2019; 10(2): 28-37.
[http://dx.doi.org/10.5306/wjco.v10.i2.28] [PMID: 30815369]
[15]
Eysbouts YK, Massuger LFAG, IntHout J, Lok CAR, Sweep FCGJ, Ottevanger PB. The added value of hysterectomy in the management of gestational trophoblastic neoplasia. Gynecol Oncol 2017; 145(3): 536-42.
[http://dx.doi.org/10.1016/j.ygyno.2017.03.018] [PMID: 28390821]
[16]
Abu-Rustum NR, Yashar CM, Bean S, et al. Gestational trophoblastic neoplasia, version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2019; 17(11): 1374-91.
[http://dx.doi.org/10.6004/jnccn.2019.0053] [PMID: 31693991]
[17]
Seckl MJ, Sebire NJ, Fisher RA, Golfier F, Massuger L, Sessa C. Gestational trophoblastic disease: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24(S6): vi39-50.
[http://dx.doi.org/10.1093/annonc/mdt345] [PMID: 23999759]
[18]
FIGO Oncology Committee. FIGO staging for gestational trophoblastic neoplasia 2000. Int J Gynaecol Obstet 2002; 77(3): 285-7.
[http://dx.doi.org/10.1016/S0020-7292(02)00063-2] [PMID: 12065144]
[19]
Mutch DG, Soper JT, Babcock CJ, Clarke-Pearson DL, Hammond CB. Recurrent gestational trophoblastic disease. Experience of the southeastern regional trophoblastic disease center. Cancer 1990; 66(5): 978-82.
[http://dx.doi.org/10.1002/1097-0142(19900901)66:5<978::AID-CNCR2820660529>3.0.CO;2-3] [PMID: 2167150]
[20]
Ngan HY, Tam KF, Lam KW, Chan KK. Relapsed gestational trophoblastic neoplasia: A 20-year experience. J Reprod Med 2006; 51(10): 829-34.
[PMID: 17086812]
[21]
Balachandran K, Salawu A, Ghorani E, et al. When to stop human chorionic gonadotrophin (hCG) surveillance after treatment with chemotherapy for gestational trophoblastic neoplasia (GTN): A national analysis on over 4,000 patients. Gynecol Oncol 2019; 155(1): 8-12.
[http://dx.doi.org/10.1016/j.ygyno.2019.07.024] [PMID: 31375268]

© 2024 Bentham Science Publishers | Privacy Policy