Primary vaginal gestational trophoblastic neoplasia treated with uterine angiographic embolization and Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide, and Vincristine: Philippines’ first reported case
- Author:
Maria Concepcion D. Cenizal‑Santos
1
;
Angelica Anne A. Chua
1
;
Leo Francis N. Aquilizan
1
Author Information
- Publication Type:Case Reports
- Keywords: Angiographic embolization; Extrauterine gestational trophoblastic neoplasia; Vaginal gestational trophoblastic neoplasia
- MeSH: Trophoblastic Neoplasms; Embolization, Therapeutic; Pregnancy, Ectopic
- From: Philippine Journal of Obstetrics and Gynecology 2022;46(4):177-181
- CountryPhilippines
- Language:English
- Abstract: Gestational trophoblastic neoplasia (GTN) in itself is an uncommon condition, much so is 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 literature. This is a case of a 26 year old G1P0 (0010) who came in for profuse vaginal bleeding. Serum beta‑human chorionic gonadotropin (β‑hCG) was elevated and ultrasound showed 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:PhilippJObstetGynecol464177-35133_000035 (1).pdf
