Ruptured arteriovenous malformation secondary to placental site trophoblastic tumor: A diagnostic dilemma and its successful management

We report a very rare case of PSTT presenting as massive hemoperitoneum caused by rupture of secondary arteriovenous malformation. MR angiogram revealed the presence of arteriovenous malformation and the diagnosis of the neoplasm was confirmed on histopathology and immunohistochemistry. Hysterectomy was done and the patient was managed successfully.
Source: The Egyptian Journal of Radiology and Nuclear Medicine - Category: Nuclear Medicine Source Type: research

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Publication date: Available online 13 February 2020Source: Gynecologic Oncology ReportsAuthor(s): Amy L. Alexander, Anna E. Strohl, Kruti P. Maniar, John R. LurainAbstractPlacental site trophoblastic tumor (PSTT) is a rare variant of gestational trophoblastic neoplasia (GTN) that is characterized by slow growth resulting in mostly uterine-confined disease, low human chorionic gonadotropin (hCG) levels, and resistance to chemotherapy.Our objective was to update our center’s experience with PSTT with respect to presentation, prognostic factors, treatment, and outcomes from 2003 to 2019.Thirteen women with PSTT were ide...
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research
CONCLUSION: Based on the good therapeutic effect and tolerable toxicity, we recommend Act-D salvage therapy for all patients with low-risk GTN who fail primary MTX chemotherapy. The higher serum hCG levels before Act-D salvage therapy may be associated with resistance to this treatment. PMID: 32026657 [PubMed - as supplied by publisher]
Source: Journal of Gynecologic Oncology - Category: OBGYN Tags: J Gynecol Oncol Source Type: research
ConclusionsPatients with recurrent GTN are prone to recurring for a second time. Surgery plays a beneficial role in the management of recurrent GTN. An interval between antecedent pregnancy and chemotherapy>12  months, and an interval from first chemotherapy to achieving β‐hCG normalization>14  weeks were predictors of recurrence.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
tz RS Abstract OBJECTIVES: The purpose of this study was to evaluate both the outcomes and toxicity of second-line actinomycin D (ActD) chemotherapy in methotrexate (MTX) - resistant low-risk postmolar gestational trophoblastic neoplasia (GTN) with 5-day ActD versus pulsed ActD. METHODS: This retrospective cohort study included patients with MTX-resistant low-risk postmolar GTN from 1974 to 2016. Second-line chemotherapy consisted of 5-day ActD (10-12 μg/kg per day for 5 days every 14 days) or biweekly ActD (1.25 mg/m2 every 2 weeks). Data on patient characteristics, disease presentation, treatme...
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
Publication date: Available online 30 January 2020Source: Gynecologic Oncology ReportsAuthor(s): Gizelka David-West, Sumithra Jeganathan, Natalie Cohen, Shekher Maddineni, Barak Friedman, Samantha Cohen
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research
We present a rare case of metastatic choriocarcinoma.Case presentationA 47-year-old woman presented with shortness of breath, anemia and an elevated serum BhCG level. Her most recent known pregnancy was 12 years previously. Following investigation, she was found to have FIGO stage IV choriocarcinoma with brain metastasis, despite having not experienced any abnormal vaginal bleeding. She was treated with chemotherapy; her treatment was complicated by neutropenic sepsis and a visceral perforation. The patient went into remission and received long-term follow-up.DiscussionIt is unclear in this case whether the disease occur...
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research
Abstract OBJECTIVE: To investigate the relationship between previous cesarean section (C/S) and risk for post-molar gestational trophoblastic neoplasia (GTN). METHODS: Data from patients who were treated for hydatidiform moles between 1995 and 2016 were retrospectively reviewed. Patient age, gravidity, parity, abortion history, gestational age, pretreatment beta-human chorionic gonadotropin (HCG), previous molar pregnancy, clinical symptoms, enlarged uterus, theca lutein cyst, type of GTN, World Health Organization risk score, chemotherapy, and mode of delivery were recorded. Hazard ratios (HR) and 95% confid...
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
tz RS Abstract OBJECTIVE: To compare the outcomes of patients with low-risk gestational trophoblastic neoplasia (GTN) treated with standard 8-day methotrexate/folinic acid (MTX/FA) versus modified regimen. METHODS: Retrospective cohort study of patients with low-risk GTN followed at Rio de Janeiro Federal University, from January/1990-December/2017 with standard 8-day MTX/FA or modified regimen (MTX administered on the 8th day rather than 7th) to avoid treatment on the weekend. RESULTS: From 937 patients with low-risk GTN, 538 were treated with standard MTX/FA and 98 patients received modified regimen. B...
Source: Gynecologic Oncology - Category: Cancer & Oncology Authors: Tags: Gynecol Oncol Source Type: research
Abstract OBJECTIVES: To describe the sonographic characteristics of post-molar gestational trophoblastic neoplasia (GTN) at diagnosis and during follow up, and to correlate sonographic variables to resistance of methotrexate (MTX-R), as first line of chemotherapy. METHODS: All women treated for post-molar GTN at Karolinska University Hospital between October 2010 and December 2017, were retrospectively included. Women with uterine lesions were followed with repeated scans during and after treatment in case of persistent lesions. MTX-R was correlated to sonographic findings at inclusion. RESULTS: Of 47 el...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
A complete hydatidiform mole (CHM) is androgenetic in origin and characterized by enhanced trophoblastic proliferation and the absence of fetal tissue. In 15 to 20% of cases, CHMs are followed by malignant gestational trophoblastic neoplasms including choriocarcinoma. Aberrant genomic imprinting may be responsible for trophoblast hypertrophy in CHMs, but the...
Source: Proceedings of the National Academy of Sciences - Category: Science Authors: Tags: Biological Sciences Source Type: research
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