AI Article Synopsis
- Gestational trophoblastic neoplasia, particularly stage IV choriocarcinoma, is rare in term pregnancies and can be life-threatening due to complications like hemorrhage.
- A 30-year-old woman at 34 weeks of pregnancy experienced severe symptoms including cough, difficulty breathing, and vaginal bleeding, leading to a cesarean delivery.
- After diagnosis of choriocarcinoma and confirmation of advanced disease, she achieved remission with chemotherapy following the delivery.
Article Abstract
Background: Gestational trophoblastic neoplasia rarely occurs in term pregnancies. Stage IV choriocarcinoma treated with conventional chemotherapy can result in death as a result of hemorrhagic sequelae at tumor sites.
Case: A 30-year-old woman at 34 weeks of gestation presented with a persistent cough, worsening dyspnea, and vaginal bleeding. Chest radiograph demonstrated innumerable lung nodules, and quantitative β-hcg concentration exceeded 1.3 million milli-international units/mL. Cesarean delivery was performed for presumed abruption. Placental pathology demonstrated choriocarcinoma, and imaging confirmed stage IV disease with a World Health Organization score of 14. Remission was achieved after two courses of low-dose induction chemotherapy followed by 10 cycles of combination chemotherapy.
Conclusion: Gestational trophoblastic neoplasia should be considered in a pregnant or postpartum woman presenting with atypical vaginal bleeding. Coexistent pulmonary or neurologic findings may suggest advanced disease.
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| http://dx.doi.org/10.1097/AOG.0000000000003001 | DOI Listing |
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