Psychiatric Liaison Programs are designed to provide service, training and research technology using the biopsychosocial approach for problems encountered in a general hospital ward or specialty clinic. When psychosocial problems arise in individuals or groups comprehensive liaison programs are designed based on an analysis of needs that consider the psychosocial dynamics of patients, their family, nursing staff, and medical staff of that particular ward or clinic. These programs are created and implemented by a multidisciplinary team of psychiatrists, social worker, nurse, OT/PT, and consultee physician. Liaison Programs have been set up at the Trophoblastic Disease Ward and the Cancer Institute of the Philippine General Hospital. Among the interventions set up are regular group therapy sessions for patients and their relatives, expressive therapy including visual art therapy, and music, relaxation techniques, meditation, and guided imagery activities, and activity therapy. For the nursing and medical staff seminars and workshops were held to aid in the detection and early intervention-of behavioral problems. Group therapy sessions were also done when interpersonal problems and burn-out were detected; Individual psychotherapy was done when the need arose. At the Trophoblastic Disease Ward, the physiological, psychological and social domains of the WHO-DOH Quality of Life questionnaire were administered to in-patient before instituting the Liaison Program, and six months after. A comparison of the pre-test and post-test scores showed a significant improvement in all the domains a p-0.05 level of significance. A Purpose-in-life test was also administered to the bantays of these patients which showed significant improvement in their scores after six months at p-0.05 level of significance. Subjective evaluations done on the ward staff showed an improvement in interpersonal relationships with other staff, patients and their bantays. We endorse Psychiatric Liaison Programs as effective interventions in dealing with the psychosocial problems of cancer patients, their bantays, and the ward staff.
TROPHOBLASTIC NEOPLASMS

No abstract available.
Trophoblastic Neoplasms* ; Trophoblasts*

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.
Trophoblastic Neoplasms ; Embolization, Therapeutic

No abstract available.
Classification* ; Risk Factors* ; Trophoblastic Neoplasms* ; Trophoblasts*

292 patients with gestational trophoblastic tumor diagnosed by beta-hCG assay were treated with chemotherapy. The rate of hysterectomy performed before chemotherapy is higher than that during and after chemotherapy. This rate is higher in the group of metastasis subjects than in no metastasis subject group. The rate of single chemotherapy resistance of hysterectomy group is lower in the case of hysterectomy performed before chemotherapy than in the case during and after chemotherapy
Hysterectomy ; Gestational Trophoblastic Neoplasms ; Patients ; Therapeutics

Persistent gestational trophoblastic tumor develops in about 15-25% after evacuation of complete mole, and arises in about 4-5% after removal of partial mole. Especially there is reported that choriocarcinoma after evacuation of partial mole is extremely rare, and it is well responded to systemic chemotherapy. We have experienced that a case of choriocarcinoma which was developed after evacuation of partial mole. So we report this case with a brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Female ; Pregnancy ; Trophoblastic Neoplasms

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.
Trophoblastic Neoplasms ; Embolization, Therapeutic ; Pregnancy, Ectopic

Humans ; Female ; Pregnancy ; Trophoblastic Neoplasms/surgery*

Gestational trophoblastic neoplasia (GTN) with a concurrent cervical malignancy is very rare, making the case both a diagnostic dilemma and a therapeutic challenge. Currently, there has only been one reported case worldwide. We present a case of GTN Stage I:11 with non‑keratinizing squamous cell carcinoma of the cervix Stage II‑B. Initial treatment, in the form of chemotherapy, was directed toward the GTN, as this appeared to be the more aggressive disease. Surgery was not feasible during diagnosis due to the cervical carcinoma. However, the GTN proved resistant to chemotherapy due to the increasing beta human chorionic gonadotropin titers. An attempt to decrease the size of the cervix for surgery to be possible through chemoradiation was instituted, but due to complications and tumor progression to the lungs, she succumbed to the malignancy.
Uterine Cervical Neoplasms ; Gestational Trophoblastic Disease

Epithelioid trophoblastic tumor (ETT) is a very rare variant of gestational trophoblastic disease (GTD) which arises in reproductive age women with prior gestational history. Although abnormal vaginal bleeding is the most common symptom of ETT, there are no reported pathognomonic symptoms of ETT because of its rarity. ETT is similar to placental site trophoblastic tumor in terms of its slow growing characteristic and microscopic findings. Therefore, it could be misdiagnosed as placental site trophoblastic tumor or other types of GTD. Unlike other types of GTD, primary treatment of ETT is surgical resection because of its chemo-resistant nature. Accordingly, immunohistochemical staining is essential for accurate diagnosis and appropriate treatment. Here, we report a case of a 42-year-old hysterectomized woman with pelvic masses who suffered from abdominal pain. Through laparotomy, tumors were resected completely and they were diagnosed as ETT through immunohistochemical stain. This report provides more evidence about its clinical features, diagnosis, and treatment including a brief review of the literature.
Abdominal Pain ; Adult ; Diagnosis ; Female ; Gestational Trophoblastic Disease ; Humans ; Laparotomy ; Trophoblastic Neoplasms* ; Trophoblastic Tumor, Placental Site ; Trophoblasts* ; Uterine Hemorrhage