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Laparoscopic diagnosis and treatment of an isolated epithelioid trophoblastic tumor in recto-uterine pouch.
- Source :
-
The journal of obstetrics and gynaecology research [J Obstet Gynaecol Res] 2018 May; Vol. 44 (5), pp. 960-965. Date of Electronic Publication: 2018 Feb 13. - Publication Year :
- 2018
-
Abstract
- A 30-year-old Chinese woman with irregular vaginal bleeding was admitted to our department. Serum β-human chorionic gonadotropin (β-hCG) was moderately elevated, and ultrasound and magnetic resonance imaging revealed an irregular, retro-uterine lesion without intrauterine pregnancy. Ectopic pregnancy was the primary consideration, with trophoblastic tumor being another possibility. Laparoscopy revealed a 2 × 3 × 3 cm <superscript>3</superscript> irregular, infiltrating, yellow-white lesion in the left recto-uterine pouch, which was completely resected without rectal damage. Final pathological/immunohistochemical analyses revealed an epithelial trophoblastic tumor (ETT) (Ki-67 reactive index~45%). Postoperative recovery was smooth, and the patient received three chemotherapy courses (etoposide, methotrexate and actinomycin, alternating weekly with cyclophosphamide and vincristine) beginning 6 days postsurgery (β-hCG = 46.4 mIU/mL). β-hCG returned to an undetectable level after one chemotherapy course. Herein, we describe a rare case of isolated ETT that was difficult to differentiate from other pregnancy-related diseases. Laparoscopy could be an effective, safe diagnostic method in select patients.<br /> (© 2018 Japan Society of Obstetrics and Gynecology.)
- Subjects :
- Adult
Female
Humans
Pregnancy
Douglas' Pouch diagnostic imaging
Douglas' Pouch pathology
Douglas' Pouch surgery
Gestational Trophoblastic Disease diagnostic imaging
Gestational Trophoblastic Disease pathology
Gestational Trophoblastic Disease surgery
Laparoscopy methods
Peritoneal Neoplasms diagnostic imaging
Peritoneal Neoplasms pathology
Peritoneal Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1447-0756
- Volume :
- 44
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The journal of obstetrics and gynaecology research
- Publication Type :
- Report
- Accession number :
- 29436119
- Full Text :
- https://doi.org/10.1111/jog.13593