1/151. Latent vaginal choriocarcinoma in a postmenopausal woman.A 50-year-old Japanese female with choriocarcinoma showed three unusual features: the primary tumor developed in the vagina ectopically without uterine lesion; the first symptoms of atypical vaginal bleeding and coughing occurred 23 years after the last pregnancy; and the tumor appeared during postmenopause. The possible mechanisms for the ectopic location and latency are discussed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/151. Metastatic lung choriocarcinoma resected nine years after hydatidiform mole.A 38-year-old woman with metastatic choriocarcinoma of the lung had been treated for a hydatidiform mole nine years previously. During the interval she had conceived and given birth to a child. Following lobectomy she has been metastasis-free for five years.- - - - - - - - - - ranking = 926.84776876009keywords = hydatidiform mole, hydatidiform, mole (Clic here for more details about this article) |
3/151. choriocarcinoma co-existent with an intact pregnancy: case report and review of the literature.A patient presenting with antepartum haemorrhage due to a vaginal metastasis of choriocarcinoma is reported. Following delivery she was successfully treated with chemotherapy and surgery. This report details this unusual presentation and reviews the literature on this rare condition.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
4/151. False diagnosis and needless therapy of presumed malignant disease in women with false-positive human chorionic gonadotropin concentrations.BACKGROUND: 12 women were diagnosed of having postgestational choriocarcinoma on the basis of persistently positive human chorionic gonadotropin (hCG) test results in the absence of pregnancy. Most of the women had extirpative surgery or chemotherapy, or both, without significant diminution in hCG titre. Our aim was to assess whether the hCG concentrations were false-positive test results. methods: Samples were tested for hCG, hCG free beta subunit, and hCG beta-core fragment. Assay kinetics were also assessed, and samples were tested independently by competitive RIA. False-positive hCG concentrations were identified by two criteria: detection of hCG in serum and lack of detection of hCG and its degradation products in urine; and wide variations in results for different hCG assays. We corroborated false-positive hCG values by the lack of parallel changes in hCG results when serum was diluted, by false detection of other antigens, and by failure to detect hCG with in-house assays. FINDINGS: All 12 women met both criteria for false-positive hCG, and all had corroborating findings. In all 12 cases, a false diagnosis had been made, and most of the women had been subjected to needless surgery or chemotherapy. Assay kinetics indicated that heterophilic antibodies were responsible for the false-positive results. As a result of our findings all further therapy was stopped. INTERPRETATION: Current protocols for the diagnosis and treatment of choriocarcinoma should be modified to include a compulsory test for hCG in urine.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
5/151. Chorioepithelioma presenting as a bleeding gingival mass.A case is reported in which a very malignant neoplasm appeared clinically to be a pregnancy tumor or a hemangioma. There was, of course, no question as to the cause of death in this particular case. It was of interest because of the rarity of the tumor, the metastasis to the oral cavity, and the fact that the final diagnosis was established from pathologic examination. The case demonstrates, with emphasis, the great importance of biopsy and routine pathologic examination of all tissue for accurate and correct diagnosis, regardless of its clinical appearance.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
6/151. An unusual case of choriocarcinoma following live term pregnancy.Post-term choriocarcinoma is an infrequent event with poor prognosis. The diagnosis is usually delayed due to failure to recognise the mode of presentation of this disease. Being a rare occurrence, limited data is available regarding its clinical features. The choriocarcinoma in our patient presented as an isolated huge pedunculated growth over the uterine serosa without intrauterine involvement and distant metastasis.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
7/151. choriocarcinoma and partial hydatidiform moles.BACKGROUND: Partial hydatidiform moles (PMs) rarely require chemotherapy and have never previously been proven to transform into choriocarcinoma, the most malignant form of gestational trophoblastic disease (GTD). Consequently, some have questioned whether women with PMs need human chorionic gonadotropin (hCG) follow-up. Here, we investigate whether PMs can transform into choriocarcinomas. methods: patients with a PM who developed a subsequent choriocarcinoma were identified from our GTD database. The histology of both PM and ensuing choriocarcinoma was reviewed and flow cytometry used to verify the triploid status of the PMs. To determine whether the choriocarcinoma arose from the PM, dna from the PM and choriocarcinoma in each patient was compared using microsatellite polymorphisms. FINDINGS: Of the 3000 patients with PM, 15 required chemotherapy for persisting GTD. This was identified as choriocarcinoma in three cases. In one patient, the local pathologist could not differentiate between a PM or a hydropic abortion and neither central histological review nor hCG follow-up were obtained. This patient nearly died before the diagnosis of choriocarcinoma was made. Fortunately, the local pathologists correctly diagnosed PM in the two other patients who were then registered for hCG follow-up. Some months later, the hCG was rising and repeat uterine evacuation revealed choriocarcinoma. The PM was confirmed to be triploid in all three cases and genetic analysis showed that the subsequent choriocarcinomas contained identical single maternal and two paternal alleles at several independent loci. INTERPRETATION: Our results show that PMs can transform into choriocarcinoma. All patients with suspected PM should be reviewed centrally and, if confirmed, need hCG follow-up.- - - - - - - - - - ranking = 926.84776876009keywords = hydatidiform mole, hydatidiform, mole (Clic here for more details about this article) |
8/151. thyrotoxicosis in a male patient associated with excess human chorionic gonadotropin production by germ cell tumor.We report a case of a man with thyrotoxicosis due to excess production of human chorionic gonadotropin (hCG) by metastatic choriocarcinoma, followed by alterations of his thyroid function tests by nonthyroidal illness. All reported cases of thyrotoxicosis due to high hCG levels in male patients are reviewed. patients with this syndrome usually have widespread choriocarcinoma and relatively few symptoms of thyrotoxicosis. Typically, if the patient survives the metastatic germ cell tumor, the thyrotoxicosis resolves as the hCG levels decrease after chemotherapy directed at the choriocarcinoma. Only rarely are specific antithyroid medications required. The hCG molecule directly stimulates the thyroid gland, and these patients appear to have in the serum a predominance of acidic variants of hCG with greater intrinsic thyroid-stimulating activity than the hCG secreted during a normal pregnancy. In general, these patients have a poor prognosis due to the usually widespread nature of the germ cell tumor at the time of diagnosis.- - - - - - - - - - ranking = 6.8534771826351keywords = mole, pregnancy (Clic here for more details about this article) |
9/151. fertility-sparing surgery, with subsequent pregnancy, in persistent gestational trophoblastic neoplasia: case report.Gestational trophoblastic neoplasia (GTN) is primarily a disease of women of reproductive age. In most instances, it is cured by surgical evacuation of the uterus, with persistent disease being very sensitive to chemotherapy. hysterectomy, recommended for persistent chemotherapy-resistant uterine disease, may be unacceptable to the woman who wishes to maintain her fertility. Uterine resection of localized disease, with uterine reconstruction, may be a viable alternative. A case is presented of a woman with persistent uterine GTN, treated with localized uterine resection and reconstruction, followed by two successful pregnancies and deliveries. The literature is reviewed and potential pregnancy complications of this management, particularly uterine rupture, are discussed.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
10/151. Testicular choriocarcinoma metastatic to the skin: an additional case and literature review.choriocarcinoma, a malignancy of trophoblastic cells, is characterized by the secretion of human chorionic gonadotropin (hCG). choriocarcinoma primarily arises from the fetal (placental) trophoblasts in the setting of a molar pregnancy. Nongestational choriocarcinoma from the ovary or testis is much rarer. Testicular choriocarcinoma is a malignant tumor with great propensity for distant metastasis. The primary sites of metastasis are the lungs, liver, and brain. skin metastasis is very rare but portends a grave prognosis when diagnosed. We present the case of a 24-year-old white male with a testicular mixed germ-cell tumor with skin metastases of choriocarcinoma.- - - - - - - - - - ranking = 21.01899745739keywords = molar pregnancy, pregnancy, molar (Clic here for more details about this article) |
| | Next -> |