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1. Wu CF, Hsu CY, Chen CP: Ectopic molar pregnancy in a cesarean scar. Taiwan J Obstet Gynecol; 2006 Dec;45(4):343-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • However, she had persistent vaginal spotting and residual decidual tissue in a cesarean scar.
  • CONCLUSION: Cesarean scar pregnancy is difficult to diagnose and must be considered in the patient with a history of cesarean section who has persistent vaginal bleeding after suction curettage.
  • [MeSH-major] Cesarean Section. Cicatrix / complications. Hydatidiform Mole / ultrasonography. Uterine Diseases / complications


2. Ji YI, Jung MH: Gastrointestinal bleeding caused by ileal metastasis of a tubal complete mole: a case report. J Womens Health (Larchmt); 2010 Jun;19(6):1217-20
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  • [Title] Gastrointestinal bleeding caused by ileal metastasis of a tubal complete mole: a case report.
  • BACKGROUND: Tubal hydatidiform mole is known to be an extremely rare disease, moreover, gastrointestinal metastasis from an ectopic complete mole has never been reported.
  • MATERIALS AND METHODS: A 33-year-old woman presented with gastrointestinal bleeding.
  • She had undergone laparoscopic left salpingectomy for a tubal complete mole a month earlier.
  • An ileal invasion of mole was identified.
  • The patient received nine cycles of adjuvant methotrexate chemotherapy after small bowel resection and anastomosis.
  • She was been without recurrence 20 months after therapy.
  • CONCLUSION: Ectopic molar pregnancy with gastrointestinal metastasis carries a high risk of intestinal perforation and uncontrollable gastrointestinal bleeding.
  • Despite its rarity, gastrointestinal metastasis should nevertheless be considered a possible cause for gastrointestinal bleeding in ectopic molar pregnancy patients after elimination of the more common etiologies.
  • [MeSH-major] Gastrointestinal Hemorrhage / etiology. Hydatidiform Mole / secondary. Ileal Neoplasms / secondary. Pregnancy, Tubal

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  • (PMID = 20392142.001).
  • [ISSN] 1931-843X
  • [Journal-full-title] Journal of women's health (2002)
  • [ISO-abbreviation] J Womens Health (Larchmt)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. True DK, Thomsett M, Liley H, Chitturi S, Cincotta R, Morton A, Cotterill A: Twin pregnancy with a coexisting hydatiform mole and liveborn infant: complicated by maternal hyperthyroidism and neonatal hypothyroidism. J Paediatr Child Health; 2007 Sep;43(9):646-8
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  • [Title] Twin pregnancy with a coexisting hydatiform mole and liveborn infant: complicated by maternal hyperthyroidism and neonatal hypothyroidism.
  • A twin pregnancy with a coexisting complete hydatiform mole and a healthy fetus is rare.
  • We describe a case of a woman, 23/40 pregnant, who was diagnosed with a twin pregnancy complicated by a hydatiform mole, vaginal bleeding, hyperthyroidism and preterm labour at 26/40.
  • The baby developed biochemical hypothyroidism post-natally.
  • [MeSH-major] Antithyroid Agents / adverse effects. Hyperthyroidism / drug therapy. Hypothyroidism / complications. Propylthiouracil / adverse effects
  • [MeSH-minor] Adrenergic beta-Antagonists / therapeutic use. Adult. Female. Humans. Hydatidiform Mole. Infant, Newborn. Live Birth. Male. Pregnancy. Propranolol / therapeutic use. Thyroid Function Tests. Treatment Outcome. Twins

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  • (PMID = 17688651.001).
  • [ISSN] 1034-4810
  • [Journal-full-title] Journal of paediatrics and child health
  • [ISO-abbreviation] J Paediatr Child Health
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Adrenergic beta-Antagonists; 0 / Antithyroid Agents; 721M9407IY / Propylthiouracil; 9Y8NXQ24VQ / Propranolol
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4. Shiina H, Oka K, Okane M, Tanno W, Kawasaki T, Nakayama M: Coexisting true hermaphroditism and partial hydatidiform mole developing metastatic gestational trophoblastic tumors. A case report. Virchows Arch; 2002 Nov;441(5):514-8
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  • [Title] Coexisting true hermaphroditism and partial hydatidiform mole developing metastatic gestational trophoblastic tumors. A case report.
  • We report a fetal autopsy case that was diagnosed with a mole coexistent with a live fetus at an early gestation and finally showed coexisting true hermaphroditism of 46,XX/46,XY mosaicism and partial hydatidiform mole, developing metastatic gestational trophoblastic tumors in the lungs of the mother.
  • A 23-year-old Japanese female had a mole coexistent with a fetus and showed a high chorionic gonadotropin titer in urine and serum at 10 weeks of gestation.
  • The fetus was interrupted for gestational toxicosis and genital bleeding at 20 weeks of gestation.
  • A chromosome analysis demonstrated 46,XX and 46,XY mosaicism in both umbilical cord blood and mole samples.
  • The testis had seminiferous tubules containing primitive germ cells, immature Sertoli cells, and cytomegalic Leydig cells.
  • The patient presented multiple metastatic pulmonary tumors at 1 month after the interruption, and was treated with chemotherapy for the clinical diagnosis of gestational trophoblastic tumor metastases.
  • [MeSH-major] Disorders of Sex Development / pathology. Fetus / abnormalities. Hydatidiform Mole / pathology. Pregnancy Complications, Neoplastic / pathology. Trophoblastic Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Abortion, Therapeutic. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Dactinomycin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / radiography. Lung Neoplasms / secondary. Magnetic Resonance Imaging. Male. Methotrexate / administration & dosage. Mosaicism / genetics. Neoplasms, Multiple Primary. Pregnancy

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  • (PMID = 12447683.001).
  • [ISSN] 0945-6317
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 6PLQ3CP4P3 / Etoposide; YL5FZ2Y5U1 / Methotrexate
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5. Horn LC, Kowalzik J, Bilek K, Richter CE, Einenkel J: Clinicopathologic characteristics and subsequent pregnancy outcome in 139 complete hydatidiform moles. Eur J Obstet Gynecol Reprod Biol; 2006 Sep-Oct;128(1-2):10-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinicopathologic characteristics and subsequent pregnancy outcome in 139 complete hydatidiform moles.
  • OBJECTIVE: The most common form of gestational trophoblastic disease is the complete hydatidiform mole (CHM).
  • Clinical characteristics, the need for chemotherapy and subsequent pregnancy outcome were evaluated.
  • RESULTS: Twelve out of 151 cases were re-evaluated as hydropic abortion, as partial hydatidiform moles or were insufficient for morphologic examination and therefore excluded from further analysis.
  • The leading clinical symptoms of the remaining 139 cases were irregular vaginal bleeding (67%) and uterine enlargement (41%).
  • Twenty-six patients (19%) required chemotherapy because of gestational trophoblastic neoplasia (GTN; low-risk: 23 out of 26).
  • CONCLUSIONS: The clinical and morphologic diagnosis of CHM is a challenge, and diagnosis as well as treatment should be multidisciplinary and centralised.
  • [MeSH-major] Hydatidiform Mole / complications. Pregnancy Outcome. Uterine Neoplasms / complications

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  • (PMID = 16530318.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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6. Nizam K, Haider G, Memon N, Haider A: Gestational trophoblastic disease: experience at Nawabshah Hospital. J Ayub Med Coll Abbottabad; 2009 Jan-Mar;21(1):94-7
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  • BACKGROUND: Gestational Trophoblastic Disease (GTD) is a heterogeneous group of diseases that includes partial and complete hydatidiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumour.
  • METHODS: The case records of all the gestational trophoblastic cases during study period were analysed regarding their history, clinical examination, investigations, treatment and follow-up.
  • The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and the follow-up.
  • Of these 30 cases, 21 (70%) patients had hydatidiform mole, 7 (23.3%) patients had invasive disease and 2 (6.6%) patients had choriocarcinoma.
  • Twenty three patients (76.6%) received chemotherapy while 25 (83.3%) patients had suction evacuation and 4 (13.3%) patients underwent hysterectomy.
  • Hydatidiform mole was the commonest type of trophoblastic disease in these patients.
  • Most common presenting complaint was bleeding per vagina followed by pain in lower abdomen.
  • [MeSH-minor] Adolescent. Adult. Choriocarcinoma / diagnosis. Choriocarcinoma / epidemiology. Choriocarcinoma / therapy. Chorionic Gonadotropin, beta Subunit, Human / blood. Female. Humans. Hydatidiform Mole / diagnosis. Hydatidiform Mole / epidemiology. Hydatidiform Mole / therapy. Hydatidiform Mole, Invasive / diagnosis. Hydatidiform Mole, Invasive / epidemiology. Hydatidiform Mole, Invasive / therapy. Incidence. Pakistan / epidemiology. Pregnancy. Retrospective Studies. Trophoblastic Tumor, Placental Site / diagnosis. Trophoblastic Tumor, Placental Site / epidemiology. Trophoblastic Tumor, Placental Site / therapy. Uterine Neoplasms / diagnosis. Uterine Neoplasms / epidemiology. Uterine Neoplasms / therapy. Young Adult

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  • (PMID = 20364752.001).
  • [ISSN] 1025-9589
  • [Journal-full-title] Journal of Ayub Medical College, Abbottabad : JAMC
  • [ISO-abbreviation] J Ayub Med Coll Abbottabad
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Pakistan
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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7. Aytan H, Caliskan AC, Demirturk F, Koseoglu RD, Acu B: Cervical partial hydatidiform molar pregnancy. Gynecol Obstet Invest; 2008;66(2):142-4
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  • CASE: We report a 25-year-old, G4P1D&C2 woman with a positive pregnancy test and vaginal bleeding.
  • A cervical pregnancy with hydatidiform mole was detected on transvaginal ultrasound and color Doppler examinations.
  • Dilatation and curettage was performed and bleeding that was initially brisk ceased after bimanual pressure.
  • Serial beta-hCG measurements showed a decline without need for adjuvant chemotherapy.
  • [MeSH-major] Cervix Uteri / pathology. Hydatidiform Mole / pathology. Pregnancy, Ectopic / pathology


8. Feng FZ, Xiang Y, Wan XR, Yin SJ, Yang XY: [Clinical characteristics and management of gestational trophoblastic disease in women aged 50 years or more]. Zhonghua Fu Chan Ke Za Zhi; 2005 Sep;40(9):605-8
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  • The lesions included 5 hydatidiform moles (13%), 19 invasive moles (50%), 12 choriocarcinomas (32%) and 2 placenta site trophoblastic tumors (5%).
  • All of 38 cases presented with abnormal vaginal bleeding.
  • Twenty-three cases of hydatidiform moles were diagnosed at their first visit to the hospital, and 15 of them received prophylactic chemotherapy, of whom 10 progressed to invasive mole, 3 developed lung metastasis.
  • All of the other 8 cases without prophylactic chemotherapy progressed to malignant changes with metastasis of lung.
  • The use of prophylactic chemotherapy reduced the incidence of subsequent metastasis.
  • All of 38 cases received chemotherapy.
  • CONCLUSIONS: The diagnosis of pregnancy and pregnancy-related disease should be considered in the elderly women presenting with abnormal vaginal bleeding.
  • Once gestational trophoblastic disease in women aged 50 years or more is diagnosed, chemotherapy should be given as soon as possible.
  • [MeSH-major] Gestational Trophoblastic Disease / diagnosis. Gestational Trophoblastic Disease / drug therapy
  • [MeSH-minor] Choriocarcinoma / diagnosis. Choriocarcinoma / drug therapy. Choriocarcinoma / surgery. Female. Humans. Hydatidiform Mole / diagnosis. Hydatidiform Mole / drug therapy. Hydatidiform Mole / surgery. Middle Aged. Pregnancy. Prognosis. Retrospective Studies. Time Factors. Treatment Outcome. Uterine Hemorrhage / diagnosis

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  • (PMID = 16202316.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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9. Khan O, Middleton M: High-risk melanoma with nodal involvement in a young woman. Nat Clin Pract Oncol; 2006 Sep;3(9):517-21; quiz 522
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  • BACKGROUND: An 18-year-old female presented to her General Practitioner with a bleeding mole on her back.
  • The mole had been present since childhood but had started to bleed in the past month.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Interferon-alpha / therapeutic use. Lymph Nodes / pathology. Melanoma / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Female. Humans. Lymph Node Excision. Recombinant Proteins. Risk Factors

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  • (PMID = 16955090.001).
  • [ISSN] 1743-4254
  • [Journal-full-title] Nature clinical practice. Oncology
  • [ISO-abbreviation] Nat Clin Pract Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interferon-alpha; 0 / Recombinant Proteins; 99210-65-8 / interferon alfa-2b
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10. Qian JH, Ye DF, Xie X: [Clinical analysis of 13 cases of gestational trophoblastic tumor misdiagnosed as ectopic pregnancy]. Zhonghua Fu Chan Ke Za Zhi; 2005 Feb;40(2):91-4
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  • OBJECTIVE: To evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy.
  • RESULTS: The main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding.
  • Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole.
  • All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy.
  • CONCLUSIONS: Misdiagnosis leads to delay in therapy with resultant increased morbidity of GTT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Gestational Trophoblastic Disease / diagnosis. Pregnancy, Ectopic / diagnosis. Uterine Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Amenorrhea / etiology. Amenorrhea / pathology. Choriocarcinoma / diagnosis. Choriocarcinoma / pathology. Choriocarcinoma / therapy. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Diagnostic Errors. Drug Administration Schedule. Female. Humans. Hydatidiform Mole, Invasive / diagnosis. Hydatidiform Mole, Invasive / pathology. Hydatidiform Mole, Invasive / therapy. Methotrexate / administration & dosage. Middle Aged. Neoplasm Staging / standards. Pregnancy. Retrospective Studies


11. Kohorn EI: Persistent low-level "real" human chorionic gonadotropin: a clinical challenge and a therapeutic dilemma. Gynecol Oncol; 2002 May;85(2):315-20
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  • [Title] Persistent low-level "real" human chorionic gonadotropin: a clinical challenge and a therapeutic dilemma.
  • OBJECTIVE: The finding of persistent low-level human chorionic gonadotropin (hCG) with or without a preceding pregnancy event presents a rare but clinically important challenge and a therapeutic dilemma.
  • METHODS: Two patients presented with persistent low-level hCG after hydatidiform mole pregnancy, one after an early pregnancy loss and one as amenorrhea and irregular bleeding.
  • The hCG level of Patient 1 was responsive to hormonal contraception and disappeared with such medication.
  • Patient 4 developed metastatic placental site trophoblastic tumor after 2 1/2 years of observation of low-level hCG.
  • CONCLUSIONS: The finding of unexplainable low-level hCG in a patient without evidence of a uterine lesion or of trophoblastic metastases provides a therapeutic challenge.
  • The administration of single-agent chemotherapy had no effect on the level of hCG in the three patients to whom it was administered.
  • The administration of multiple-agent chemotherapy appears unjustified in the absence of a demonstrable trophoblastic tumor.
  • [MeSH-major] Chorionic Gonadotropin / blood. Chorionic Gonadotropin / urine. Hydatidiform Mole / blood. Hydatidiform Mole / urine
  • [MeSH-minor] Adult. Amenorrhea / blood. Amenorrhea / urine. Female. Humans. Middle Aged. Pregnancy. Trophoblastic Neoplasms / blood. Trophoblastic Neoplasms / drug therapy. Trophoblastic Neoplasms / urine. Uterine Neoplasms / blood. Uterine Neoplasms / drug therapy. Uterine Neoplasms / urine

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  • [Copyright] (c) 2002 Elsevier Science (USA).
  • (PMID = 11972394.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin
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12. Pariyar J: Gestational trophoblastic disease in Nepalese women managed in B. P. Koirala Memorial Cancer Hospital. J Clin Oncol; 2009 May 20;27(15_suppl):e16570

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The main outcomes were measured in terms of duration, antecedent pregnancy, investigations, treatment and follow-up.
  • There were 17 cases (37.8%) of hydatidiform mole, 6 were invasive mole (13.35%), 4 of persistent gestational trophoblastic tumour (8.8%) and 22 patients (48.8%) of choriocarcinoma.
  • The most common presenting symptom was vaginal bleeding and 26 (57.8%) patients had anaemia.
  • Among the 45 cases 6 (13.3%) were treated with suction evacuation only; 9 (20%) underwent hysterectomy for uterine perforation, excessive hemorrhage and invasive mole.
  • 28 (62.2%) cases underwent adjuvant chemotherapy among which 12 (26.6%) received single agent chemotherapy and 15 (33.3%) received EMA-CO regimen.

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  • (PMID = 27961513.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Cortés-Charry R, Figueira LM, García-Barriola V, de Gómez M, Vivas Z, Salazar A: Gestational trophoblastic neoplasia: clinical trends in 8 years at Hospital Universitario de Caracas. J Reprod Med; 2006 Nov;51(11):888-91

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  • Fifty-six percent were posthydatidiform mole (HM), 36% postchoriocarcinoma (CC), 4% postinvasive mole and 4% postabortion with abundant intermediate trophoblast.
  • Vaginal bleeding was the main symptom in patients with CC.
  • Fifty-two percent of cases were at stage Ib; 76% received single-agent chemotherapy.
  • Vaginal bleeding is frequent in CC and can mimic other gynecologic diseases.
  • Chemotherapy is helpful, and hysterectomy can be performed in selected cases at early stages or with severe vaginal bleed-with a good ing.
  • [MeSH-major] Choriocarcinoma / epidemiology. Gestational Trophoblastic Disease / epidemiology. Hydatidiform Mole / epidemiology

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  • (PMID = 17165435.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin
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14. Moodley M, Tunkyi K, Moodley J: Gestational trophoblastic syndrome: an audit of 112 patients. A South African experience. Int J Gynecol Cancer; 2003 Mar-Apr;13(2):234-9
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  • With the advent of sensitive assays for detection of serum beta human chorionic gonadotrophin (HCG) and ultrasound, GTD can now be detected earlier in pregnancy.
  • Of 112 patients, there were 78 patients (70%) with hydatidiform mole and 34 patients (30%) with choriocarcinoma.
  • The most common presenting symptom was vaginal bleeding (93.8%).
  • Suction curettage was the main treatment modality for patients with molar pregnancy while choriocarcinoma was treated primarily with chemotherapy.
  • A total of 72 percent of patients with molar pregnancy and 28 percent with choriocarcinoma had complete remission after initial treatment.
  • Twelve patients died during the course of treatment mainly due to late presentation and advanced metastatic disease.
  • Similar to other studies, the majority of patients with molar pregnancy were treated with suction curettage while the majority of patients with choriocarcinoma were treated with chemotherapy.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cyclophosphamide. Dactinomycin. Etoposide. Female. Humans. Hydatidiform Mole / drug therapy. Hydatidiform Mole / epidemiology. Hydatidiform Mole / etiology. Hydatidiform Mole / surgery. Incidence. Medical Audit. Medical Records. Methotrexate. Pregnancy. Retrospective Studies. South Africa / epidemiology. Vincristine

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  • (PMID = 12657130.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; YL5FZ2Y5U1 / Methotrexate; EMA-CO protocol
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15. Gurung G, Ojha N, Amatya A, Shrestha I, Kc N, Poudel S, Rana A: Live birth following treatment of post molar choriocarcinoma. Nepal Med Coll J; 2009 Mar;11(1):66-8
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  • [Title] Live birth following treatment of post molar choriocarcinoma.
  • A G3P(1+1) who underwent dilatation and curettage (D and C) for persistent vaginal bleeding after a month of molar evacuation, underwent successful treatment of choriocarcinoma with methotrexate and was able to have normal baby weighing 2800 gms with good Apgar score and normal placenta.
  • This shows that a normal menstruation and uncomplicated term delivery can be expected after complete chemotherapy for gestational trophoblastic neoplasia (GTN).
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Choriocarcinoma / drug therapy. Hydatidiform Mole / complications. Live Birth. Methotrexate / administration & dosage. Uterine Neoplasms / drug therapy

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  • (PMID = 19769244.001).
  • [Journal-full-title] Nepal Medical College journal : NMCJ
  • [ISO-abbreviation] Nepal Med Coll J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Nepal
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Chorionic Gonadotropin; YL5FZ2Y5U1 / Methotrexate
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16. Chao A, Lin CT, Chang TC, Hsueh S, Lai CH: Choriocarcinoma with diffuse intraabdominal abscess and disseminated intravascular coagulation. A case report. J Reprod Med; 2002 Aug;47(8):689-92
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  • CASE: A 29-year-old woman presented with massive vaginal bleeding, fever and severe abdominal pain.
  • Although the patient developed DIC after surgery, transfusion, antibiotics and immediate combination chemotherapy improved her condition and controlled the malignancy.
  • She was free of disease for > 20 months after treatment.
  • CONCLUSION: Timely surgery, aggressive antibiotics and immediate postoperative chemotherapy are recommended for patients with choriocarcinoma complicated by intraabdominal abscess and DIC.
  • [MeSH-major] Abdominal Abscess / etiology. Abdominal Abscess / pathology. Choriocarcinoma / complications. Choriocarcinoma / pathology. Disseminated Intravascular Coagulation / etiology. Disseminated Intravascular Coagulation / pathology. Hydatidiform Mole / complications. Hydatidiform Mole / pathology. Uterine Neoplasms / complications. Uterine Neoplasms / pathology

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  • (PMID = 12216440.001).
  • [ISSN] 0024-7758
  • [Journal-full-title] The Journal of reproductive medicine
  • [ISO-abbreviation] J Reprod Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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17. Jain KA: Gestational trophoblastic disease: pictorial review. Ultrasound Q; 2005 Dec;21(4):245-53
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  • Sonography can usually provide a specific diagnosis in abnormal first trimester bleeding.
  • Partial or complete hydatidiform moles can be diagnosed in early gestation.
  • Sonography and Doppler imaging are helpful in diagnosing gestational trophoblastic disease, in determining whether invasive disease is present, in detecting recurrent disease, and in following the effectiveness of chemotherapy.
  • [MeSH-minor] Adult. Choriocarcinoma / physiopathology. Choriocarcinoma / ultrasonography. Education, Medical, Continuing. Female. Humans. Hydatidiform Mole / physiopathology. Hydatidiform Mole / ultrasonography. Middle Aged. Neoplasm Staging. Pregnancy. Sensitivity and Specificity. Severity of Illness Index

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  • (PMID = 16344728.001).
  • [ISSN] 0894-8771
  • [Journal-full-title] Ultrasound quarterly
  • [ISO-abbreviation] Ultrasound Q
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 41
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18. Roopnarinesingh R, Igoe S, Gillan JE: Choriocarcinoma-presenting as a primary lesion of the cervix. Ir Med J; 2004 May;97(5):147-8
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  • A 25 year old nulliparous Russian lady presented to the hospital complaining of abdominal pain and mild vaginal bleeding.
  • Complete assessment by a multidisciplinary team was performed and chemotherapy (methotrexate) was commenced.
  • This case of a twenty-five year old nulliparous woman highlights the importance of appropriate follow-up in cases of irregular genital tract bleeding with a past history of trophoblastic disease.
  • [MeSH-major] Choriocarcinoma / diagnosis. Hydatidiform Mole / pathology. Neoplasm Recurrence, Local. Uterine Cervical Neoplasms / diagnosis. Uterine Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Pregnancy


19. Naito Y, Akeda K, Kasai Y, Matsumine A, Tabata T, Nagao K, Uchida A: Lumbar metastasis of choriocarcinoma. Spine (Phila Pa 1976); 2009 Jul 1;34(15):E538-43
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  • Although 2 cases of metastasis in lumbar and/or sacral vertebra have been reported, the efficacy of surgical treatment for the spinal metastasis of choriocarcinoma is not yet known.
  • METHODS: The clinical course, radiologic features, pathology, and outcome of the treatment of metastatic choriocarcinoma of the lumbar spine is reported.
  • RESULTS: A 38-year-old female patient with abnormal uterine bleeding 6 weeks after a normal-term delivery showed high serum levels of hCG.
  • After computed tomography-guided needle biopsy, a clinical and pathologic diagnosis of lumbar metastasis of choriocarcinoma was made.
  • Surgical resection of the localized L2 vertebra lesion was performed by total en bloc spondylectomy after a poor response to initial chemotherapy with methotrexate.
  • Postsurgically, the serum level of hCG explosively increased and local recurrences around the original L2 vertebra and epidural metastasis abruptly developed.
  • Because surgical resection of a lumbar metastasis of choriocarcinoma involves a substantial risk of profuse hemorrhage, local recurrence and the spread of metastasis, multiagent chemotherapy in combination with radiotherapy should be preformed before surgical resection.
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor / blood. Biopsy. Chorionic Gonadotropin / blood. Chorionic Gonadotropin / secretion. Drug Therapy / methods. Drug Therapy / standards. Epidural Neoplasms / secondary. Fatal Outcome. Female. Humans. Hydatidiform Mole / complications. Hydatidiform Mole / physiopathology. Lung Neoplasms / secondary. Neoplasm Metastasis / pathology. Neoplasm Metastasis / physiopathology. Neoplasm Recurrence, Local. Neurosurgical Procedures. Pregnancy. Treatment Failure

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  • (PMID = 19564760.001).
  • [ISSN] 1528-1159
  • [Journal-full-title] Spine
  • [ISO-abbreviation] Spine
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin
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20. Tsai CC, Cheng YF, Changchien CC, Lin H: Successful term pregnancy after selective embolization of a large postmolar uterine arteriovenous malformation. Int J Gynecol Cancer; 2006 Jan-Feb;16 Suppl 1:439-41
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  • Successful conservative treatment with subsequently conceived is rarely reported.
  • We describe a 31-year-old woman with a complex and large postmolar AVM; she was successfully treated with transarterial selective embolization for a long history of repeated excessive vaginal bleeding and anemia.
  • She resumed normal menstrual periods soon after treatment, and she subsequently conceived about 2 years later.
  • Selective embolization of a complex and large uterine AVM seems to be feasible for the treatment of uterine bleeding and preservation of reproductive capability.
  • [MeSH-major] Arteriovenous Malformations / therapy. Embolization, Therapeutic. Pregnancy Complications. Uterine Diseases / therapy. Uterus / blood supply
  • [MeSH-minor] Adult. Female. Humans. Hydatidiform Mole / complications. Hydatidiform Mole / drug therapy. Iliac Artery / abnormalities. Pregnancy. Pregnancy Outcome. Uterine Neoplasms / complications. Uterine Neoplasms / drug therapy

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  • [CommentIn] Int J Gynecol Cancer. 2009 May;19(4):811 [19509595.001]
  • (PMID = 16515641.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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21. Yingna S, Yang X, Xiuyu Y, Hongzhao S: Clinical characteristics and treatment of gestational trophoblastic tumor with vaginal metastasis. Gynecol Oncol; 2002 Mar;84(3):416-9
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  • [Title] Clinical characteristics and treatment of gestational trophoblastic tumor with vaginal metastasis.
  • Vaginal metastasis were documented by physical examination and tissue biopsy.
  • RESULTS: The incidence of vaginal metastasis in choriocarcinoma and invasive mole was 8.6 and 4.1%, respectively.
  • All patients were treated with 5-Fu combined chemotherapy.
  • Vaginal packing was employed to stop bleeding in 16 patients.
  • Vaginal tumors disappeared after chemotherapy.
  • 5-Fu combined chemotherapy is still a reliable method for treating vaginal metastases.
  • Angiographic embolization is emerging as a successful procedure to control the severe hemorrhage of vaginal tumors.
  • [MeSH-major] Choriocarcinoma / secondary. Choriocarcinoma / therapy. Trophoblastic Neoplasms / pathology. Trophoblastic Neoplasms / therapy. Vaginal Neoplasms / secondary. Vaginal Neoplasms / therapy
  • [MeSH-minor] Angiography / methods. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Embolization, Therapeutic / methods. Female. Fluorouracil / administration & dosage. Humans. Pregnancy. Retrospective Studies. Risk Factors. Uterine Hemorrhage / etiology. Uterine Hemorrhage / therapy

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  • (PMID = 11855880.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] U3P01618RT / Fluorouracil
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22. Piura B, Shaco-Levy R: [Placental site trophoblastic tumor]. Harefuah; 2007 Jan;146(1):62-7, 77
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  • Most patients are in their thirties and the prevailing presenting symptom is abnormal vaginal bleeding.
  • Since PSTT is less sensitive to chemotherapy than GTDs originating from cytotrophoblast and syncytiotrophoblast (hydatidiform mole, invasive mole, and choriocarcinoma), hysterectomy is the mainstay of treatment.
  • Systemic multi-agent chemotherapy is administered in the presence of disease extension beyond the uterus and considered in the presence of other adverse prognostic factors.
  • The EP/EMA regimen seems to be the most effective chemotherapy available to date for PSTT.
  • Although PSTT produces less human chorionic gonadotropin (hCG) than choriocarcinoma, beta-hCG is still the best available serum marker for monitoring the response to treatment and for follow-up.

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  • (PMID = 17294852.001).
  • [ISSN] 0017-7768
  • [Journal-full-title] Harefuah
  • [ISO-abbreviation] Harefuah
  • [Language] heb
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Israel
  • [Number-of-references] 20
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23. Lara FM, Alvarado AM, Candelaria M, Arce CS: [Gestational trophoblastic disease. Experience at National Institute of Cancerology]. Ginecol Obstet Mex; 2005 Jun;73(6):308-14
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  • INTRODUCTION: Gestational trophoblastic disease represents a variety of conditions that include hydatiform mole and choriocarcinoma.
  • PATIENTS AND METHODS: This is a retrospective and descriptive analysis of patients with partial, complete or persistent hydatiform mole or choriocarcinoma diagnosis made from January 1988 to December 2003.
  • We studied demographic characteristics, risk groups, treatment and response.
  • Vaginal bleeding was the most common manifestation at diagnosis.
  • Thirty patients had low risk disease and 25 of them received chemotherapy based in methotrexate and folinic acid, 88% had complete response.
  • In 10% of the cases the use of salvage chemotherapy showed a complete response.
  • Forty-one cases belonging to intermediate and high risk group were treated with chemotherapy (etoposide and actinomycin D in 68.3%).
  • Two cases developed second malignancies secondary to etoposide.
  • Etoposide and actynomicine D as first line chemotherapy had comparable results to those reported with EMA-CO and MAC.

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  • (PMID = 16309037.001).
  • [ISSN] 0300-9041
  • [Journal-full-title] Ginecología y obstetricia de México
  • [ISO-abbreviation] Ginecol Obstet Mex
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Mexico
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24. Baertschi E, Notter M, Mironov A, Wernli M, Bargetzi MJ: [Cerebral metastasis in choriocarcinoma a case report]. Praxis (Bern 1994); 2003 Apr 16;92(16):763-8
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  • Choriocarcinoma are malignant neoplastic tumors from the trophoblastic tissue with a tendency to early metastases.
  • In young women, symptoms like vaginal or pulmonary bleeding or neurologic disturbances shortly after a hydatiform mole or a normal pregnancy, accompanied by high levels of HCG in serum and CSF, choriocarcinoma should be considered.
  • Choriocarcinoma are very sensitive to chemotherapy, which consists--depending on the stage of the disease--of a mono- or polychemotherapy.
  • Levels of HCG in serum and cerebrospinal fluid are good markers to control the effect of therapy.
  • The presented case leads to a more optimistic attitude and demonstrates efficacy of immediately started radio- and chemotherapy.
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blindness / etiology. Cerebral Angiography. Chorionic Gonadotropin / blood. Chorionic Gonadotropin / cerebrospinal fluid. Combined Modality Therapy. Dactinomycin / therapeutic use. Doxorubicin / therapeutic use. Etoposide / therapeutic use. Female. Follow-Up Studies. Humans. Intracranial Aneurysm / complications. Intracranial Aneurysm / radiography. Leucovorin / therapeutic use. Methotrexate / therapeutic use. Pregnancy. Prognosis. Radiotherapy Dosage. Time Factors. Tomography, X-Ray Computed. Vincristine / therapeutic use

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  • (PMID = 12741100.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] Case Reports; Comparative Study; English Abstract; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; Q573I9DVLP / Leucovorin; YL5FZ2Y5U1 / Methotrexate; EMACO protocol
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25. Rauf B, Hassan L, Ahmed S: Management of gestational trophoblastic tumours: a five-year clinical experience. J Coll Physicians Surg Pak; 2004 Sep;14(9):540-4

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  • Of these 13 followed Hydatidiform Mole, 10 after abortion and 7 after a term pregnancy.
  • Ninety percent of the patients presented with vaginal bleeding, while life-threatening hemorrhage occurred in 23.3%of the cases.43.3% of the patients had hydatidiform mole as an antecedent pregnancy and 36.7% of the patients presented within four months of the antecedent pregnancy.
  • Prior chemotherapy was given in only 2 patients and both of them died due to resistance.
  • Chemotherapy was given to 100% of patients; survival was 100% in low-risk group and 50% in high-risk group (P=0.004).
  • Major side effects of chemotherapy were stomatitis (66.6%), alopecia (56.6%), low hemoglobin (60%), weight loss and recurrent infection.
  • CONCLUSION: Late diagnosis, previously failed chemotherapy and high WHO prognostic scores are major risk factors affecting outcome in these patients.
  • Hence every female in reproductive age group with unexplained bleeding per vaginum should be investigated with serum BHCG (Beta human chorionic gonadotrophin).
  • [MeSH-major] Gestational Trophoblastic Disease / diagnosis. Gestational Trophoblastic Disease / therapy
  • [MeSH-minor] Adult. Female. Follow-Up Studies. Humans. Pakistan. Prospective Studies. Treatment Outcome

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  • (PMID = 15353138.001).
  • [ISSN] 1022-386X
  • [Journal-full-title] Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • [ISO-abbreviation] J Coll Physicians Surg Pak
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Pakistan
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26. Lichtenberg ES: Gestational trophoblastic tumor after medical abortion. Obstet Gynecol; 2003 May;101(5 Pt 2):1137-9
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  • Passage of tissue ensued after mifepristone-misoprostol administration.
  • Sixty days after initial treatment, she presented to a hospital with a history of intermittent bleeding and underwent curettage, revealing a complete hydatidiform mole.
  • Chemotherapy was instituted when levels of hCG plateaued.
  • [MeSH-major] Abortifacient Agents, Steroidal / adverse effects. Abortion, Therapeutic / adverse effects. Gestational Trophoblastic Disease / diagnosis. Mifepristone / adverse effects. Misoprostol / adverse effects. Oxytocics / adverse effects
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Female. Humans. Methotrexate / therapeutic use. Pregnancy. Pregnancy Trimester, First

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  • (PMID = 12738129.001).
  • [ISSN] 0029-7844
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Abortifacient Agents, Steroidal; 0 / Antineoplastic Agents; 0 / Oxytocics; 0E43V0BB57 / Misoprostol; 320T6RNW1F / Mifepristone; YL5FZ2Y5U1 / Methotrexate
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27. Timmerman D, Van den Bosch T, Peeraer K, Debrouwere E, Van Schoubroeck D, Stockx L, Spitz B: Vascular malformations in the uterus: ultrasonographic diagnosis and conservative management. Eur J Obstet Gynecol Reprod Biol; 2000 Sep;92(1):171-8
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  • OBJECTIVE: To investigate the presence and outcome of uterine vascular malformations in women with abnormal premenopausal bleeding.
  • STUDY DESIGN: In this observational study 265 consecutive patients with abnormal premenopausal bleeding were examined by the same ultrasonographer with transvaginal gray-scale ultrasonography and color Doppler imaging.
  • Two patients with hydatiform mole needed chemotherapy and their condition normalized.

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  • (PMID = 10986453.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] IRELAND
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28. Cheng XD, Lü WG, Wan XY, Chen XD, Xie X: [Case report and literature review of epithelioid trophoblastic tumor]. Zhonghua Fu Chan Ke Za Zhi; 2008 Apr;43(4):281-5
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  • The most common presentation was abnormal vaginal bleeding (5/6).
  • The preceding gestational events were hydatidiform mole in 1 case, abortion in 2 cases, and term delivery in 3 cases.
  • The main therapies were surgery combined with chemotherapy.
  • One case had a recurrence but refused any treatment again, and was lost to follow up; the therapy of 1 case unfinished; another 4 cases were without evidence of disease 9 to 19 months after surgery.
  • The role of chemotherapy in ETT is not clear yet.
  • [MeSH-major] Trophoblastic Neoplasms / pathology. Trophoblastic Neoplasms / therapy. Uterine Neoplasms / pathology. Uterine Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Chorionic Gonadotropin / blood. Combined Modality Therapy. Epithelioid Cells / pathology. Female. Humans. Hysterectomy. Lung Neoplasms / secondary. Lung Neoplasms / therapy. Middle Aged. Neoplasm Metastasis. Pregnancy. Prognosis. Retrospective Studies

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  • (PMID = 18843970.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin
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