Primary vaginal gestational trophoblastic neoplasia treated with uterine angiographic embolization and chemotherapy
10.4103/pjog.pjog_27_22
- Author:
Maria Concepcion D. Cenizal-Santos
;
Angelica Anne A. Chua
;
Leon Francis N. Aquilizan
- Publication Type:Case Reports
- Keywords:
Angiographic embolization;
Extrauterine gestational trophoblastic neoplasia;
Vaginal gestational trophoblastic neoplasia
- MeSH:
Trophoblastic Neoplasms;
Embolization, Therapeutic
- From:
Philippine Journal of Obstetrics and Gynecology
2022;46(3):131-135
- CountryPhilippines
- Language:English
-
Abstract:
Gestational trophoblastic neoplasia (GTN) in itself is an uncommon condition, much so is a primary extrauterine GTN. The incidence of GTN in the Philippines is at 22.4/40,000 pregnancies. However, no report has been made for primary extrauterine GTN. Only two cases of primary vaginal choriocarcinoma are reported in the literature. This is a case of a 26‑year‑old gravida 1 para 0 (0010) who came in for profuse vaginal bleeding. Serum beta‑human chorionic gonadotropin (β‑hCG) was elevated and ultrasound showed a hypervascular vaginal mass and an empty uterus. A primary vaginal GTN was considered, and the patient was treated with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen. During the course of chemotherapy, there was a note of profuse vaginal bleeding, which was controlled by angiographic uterine artery embolization. A normal β‑hCG level was achieved after six cycles of EMACO. The patient was able to have three successful pregnancy outcomes thereafter. Primary vaginal GTN is a rare condition that requires a high index of suspicion. In a nulliparous patient complicated with profuse vaginal bleeding, angiographic embolization is an effective fertility‑sparing procedure that can manage the said complication.
- Full text:PhilippJObstetGynecol463131-2056227_054242.pdf
