Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy
Abstract
1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Gestational Type | Non-Gestational Type |
---|---|---|
Age | Reproductive period | Average age of 13 years, most patients are under 20 |
History of normal, molar, or ectopic pregnancy or miscarriage | Yes | No |
Histology | / | Elements of other germ cell tumours are significant for mixed-type |
Corpus luteum | Yes | No |
Genome | Totally or partially different from the patient | Identical to the patient |
Serum β-hCG | Higher | Lower |
Treatment | Low-risk: single agent (methotrexate, actinomycin D or etoposide) High-risk: combination chemotherapy (e.g., EMA-CO) | Mixed-type: surgery and BEP regimen Pure type: cisplatin regimens (e.g., BEP) |
Prognosis | Better | Worse (especially pure type) |
Age | Clinical Presentation | βhCG (mlU/mL) | Surgery | Metastasis at the Time of Diagnosis | FIGO Grade/WHO Risk Score | Chemotherapy | Outcome | Gestational Origin Confirmed | |
---|---|---|---|---|---|---|---|---|---|
Our case | 44 | Abdominal pain, vaginal bleeding | >225,000 | Laparoscopic right-sided adnexectomy | Liver, lung, bone | FIGO IV WHO 16 | EP, EMA-CO | complete remission | no |
Sakurai et al., 2022 [5] | 38 | Lower left abdominal pain and abdominal distension | 2.7 × 106 | 1st surgery: left salpingo-oophorectomy and right ovarian biopsy. Artificial abortion of viable intrauterine pregnancy. 2nd surgery: total hysterectomy including the residual tumor, right salpingo-oophorectomy, and omentectomy. | no | FIGO II WHO 13 | EMA-CO | complete remission | yes |
Kazemi et al., 2022 [22] | 35 | Severe pelvic pain, fatigue, nausea, vomiting, cough | 33,827 | Laparotomy, not specified | lung, brain, kidney, spleen | FIGO IV | EMA-EP, EMA-CO, Relapse: 3 cycles of paclitaxel, cisplatin, etoposide, 4 cycles of liposomal doxorubicin and carboplatin, 5 cycles of fluorouracil and dactinomycin | Relapse, death 8 months from the initial diagnosis | no |
Adow et al., 2021 [16] | 25 | Lower abdominal swelling and pain | 1,000,000 | Total abdominal hysterectomy and bilateral salpingo-oophorectomy | not mentioned | / | BEP | Complete remission | no |
Jia et al., 2017 [21] | 27 | Amenorrhea, lower abdominal pain and vaginal bleeding | >200,000 | Laparoscopic exploration, dissection of the cystic mass of the right ovary | no | / | EP-EMA | Complete remission, patient gave birth 25 months after chemotherapy | yes |
Haruma et al., 2015 [23] | 19 | Lower abdominal pain, amenorrhea | 373,170 | Left salpingo-oophorectomy | lung, peritoneum, pelvis | FIGO III, WHO > 7 (high risk) | EMA-CO | Complete remission | no |
Naniwadekar et al., 2009 [19] | 19 | Abdominal pain, vaginal bleeding, palpable abdominal mass | 380,000 | Total hysterectomy with removal of bilateral ovarian masses with omentectomy | no | / | EMA-CO | Lost to follow-up after second course of chemotherapy | no |
Mood et al., 2009 [14] | 31 | Signs of acute abdomen and spotting | >1000 | Right salpingo-oophorectomy | no | / | EMA-CE | complete remission | no |
Gerson et al., 2005 [24] | 33 | Right lower quadrant abdominal pain | 564,000 | First surgery: laparoscopic right salpingo-oophorectomy and resection of a right adnexal mass Second surgery: total abdominal hysterectomy and left salpingectomy | spleen | / | EMA-CO | complete remission | no |
Vautier-Rit et al., 2004 [25] | 32 | Pelvic pain, vaginal bleeding | 315,000 | Left-sided ovariectomy | no | FIGO Ic | EP | complete remission | yes |
Aucouturier et al., 2003 [26] | 43 | Abdominal pain | 37,260 | Total hysterectomy with left-sided adnexectomy and omentectomy, multiple peritoneal biopsies | lung | T3c NO | EP | complete remission | no |
Namba et al., 2003 [27] | 37 | Amenorrhea | 990,000 | Right salpingo-oophorectomy and a curettage of the uterus | no | / | Methotrexate, actinomycin D, cyclophosphamide as neoadjuvant therapy; methotrexate, actinomycin D, cyclophosphamide as consolidation therapy | The patient remains after follow-up with no signs of recurrence | yes |
Lorigan et al., 1996 [28] | 41 | Amenorrhea, vaginal bleeding | 151,500 | Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy | no | / | BEP, salvage therapy Ifosfamide and etoposide | complete remission | yes |
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Malovrh, E.P.; Lukinovič, N.; Bujas, T.; Sobočan, M.; Knez, J. Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy. Curr. Oncol. 2023, 30, 2217-2226. https://doi.org/10.3390/curroncol30020171
Malovrh EP, Lukinovič N, Bujas T, Sobočan M, Knez J. Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy. Current Oncology. 2023; 30(2):2217-2226. https://doi.org/10.3390/curroncol30020171
Chicago/Turabian StyleMalovrh, Eva Pavla, Nuša Lukinovič, Tatjana Bujas, Monika Sobočan, and Jure Knez. 2023. "Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy" Current Oncology 30, no. 2: 2217-2226. https://doi.org/10.3390/curroncol30020171
APA StyleMalovrh, E. P., Lukinovič, N., Bujas, T., Sobočan, M., & Knez, J. (2023). Ultra-High-Risk Gestational Choriocarcinoma of the Ovary Associated with Ectopic Pregnancy. Current Oncology, 30(2), 2217-2226. https://doi.org/10.3390/curroncol30020171