Extrauterine Choriocarcinoma in the Fallopian Tube Following Infertility Treatment: Implications for the Management of Early-Detected Ectopic Pregnancies.
| Autor: | Jwa SC; Sora no Mori Clinic, Okinawa, Japan. Electronic address: jwa.seung@gmail.com., Kamiyama S; Sora no Mori Clinic, Okinawa, Japan., Takayama H; Sora no Mori Clinic, Okinawa, Japan., Tokunaga Y; Sora no Mori Clinic, Okinawa, Japan., Sakumoto T; Sora no Mori Clinic, Okinawa, Japan., Higashi M; Department of Obstetrics and Gynecology, Tomishiro Central Hospital, Okinawa, Japan. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2017 Jul - Aug; Vol. 24 (5), pp. 855-858. Date of Electronic Publication: 2017 Mar 14. |
| DOI: | 10.1016/j.jmig.2017.03.006 |
| Abstrakt: | Extrauterine choriocarcinoma in the fallopian tube is very rare and is often diagnosed and treated as an ectopic tubal pregnancy. A 34-year-old woman who initially became pregnant after infertility treatment using ovulation induction with clomiphene citrate and intrauterine insemination was later diagnosed with an extrauterine choriocarcinoma in the left fallopian tube. Because of suspected left ectopic tubal pregnancy based on ultrasonography findings and a high level of β-human chorionic gonadotropin (β-hCG; 7054.3 mIU/mL), the patient underwent diagnostic laparoscopy at a gestational age of 6 weeks. Left salpingectomy was performed based on the operative diagnosis of an ectopic tubal pregnancy. No signs of tubal rupture or leakage of contents from the fallopian tube were observed during the operation. Her serum β-hCG dropped to 10.3 mIU/mL at 15 days postoperatively. Histopathology demonstrated an extrauterine choriocarcinoma in the removed fallopian tube, and the patient was referred to a regional oncologic hospital to receive additional adjuvant chemotherapy. This case indicates that conservative treatment for ectopic pregnancy should be chosen carefully, and that histopathology diagnosis and appropriate β-hCG monitoring following treatment are important not only to diagnose persistent ectopic pregnancy, but also to rule out the possibility of a tubal choriocarcinoma. (Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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