Autor: |
Cronin S; Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, PA 19141, USA., Ahmed N; Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, PA 19141, USA., Craig AD; Department of Surgical Oncology, Division of Gynecology Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA., King S; Department of Surgical Oncology, Division of Gynecology Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA., Huang M; Department of Pathology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA., Chu CS; Department of Surgical Oncology, Division of Gynecology Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA., Mantia-Smaldone GM; Department of Surgical Oncology, Division of Gynecology Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. |
Abstrakt: |
Non-Gestational Ovarian Choriocarcinoma (NGOC) is an extremely rare ovarian tumor, with an incidence of less than 0.6% of malignant ovarian germ cell tumors. Its close pathologic resemblance to Gestational Ovarian Choriocarcinoma (GOC), however, requires special attention as the treatments differ greatly. NGOC typically affects patients in late adolescence or early reproductive years. As a result, NGOCs are often misdiagnosed as ectopic pregnancies due to their common presentation of bleeding, abdominal pain, adnexal mass, and positive serum beta-HCG. On pathologic examination, the tumor is indistinguishable from GOC, and only after review of tissue for paternal genetic components can the diagnosis of NGOC be made. Imaging studies often show highly vascular lesions with further investigation with computer topography (CT) sometimes showing metastatic lesions in the lungs, pelvis, vagina, and liver. These lesions are often hemorrhagic and can lead to catastrophic bleeding. Treatment is vastly different from GOC; NGOC requires treatment with both surgical resection and chemotherapy, with Bleomycin, Etoposide, and Cisplatin (BEP) being the most used regimen. With correct diagnosis and treatment, patients can often receive fertility sparing treatment with long term survival. |