Ultrasonic morphology of the uterus and ovaries after treatment of invasive mole and gestational choriocarcinoma
| Autor: | R. H. J. Begent, J. E. Boultbee, M. G. Long, K. D. Bagshawe |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Uterus Antineoplastic Agents Gestational choriocarcinoma Molar pregnancy Pregnancy Mole Humans Medicine Radiology Nuclear Medicine and imaging Choriocarcinoma Prospective Studies reproductive and urinary physiology Ultrasonography Gynecology Chemotherapy Hysterectomy Hydatidiform Mole Invasive business.industry Ovary General Medicine Prognosis medicine.disease female genital diseases and pregnancy complications Ovarian Cysts medicine.anatomical_structure Uterine Neoplasms Gestation Female Neoplasm Recurrence Local business |
| Zdroj: | The British Journal of Radiology. 63:942-945 |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/0007-1285-63-756-942 |
| Popis: | Ultrasound imaging of the uterus and ovaries was performed on 41 patients after completion of apparently successful cytotoxic chemotherapy for invasive mole and choriocarcinoma. Uterine volume was calculated and the echopattern of the uterus and ovaries assessed. Forty-nine per cent of subjects had an abnormal uterine appearance and 20% had ovarian theca-lutein cysts. Two patients relapsed on follow-up but no predictive ultrasonic features could be established on uterine or ovarian morphology after chemotherapy. Hydatidiform mole is an abnormal product of concep- tion and has an incidence of approximately once for every 1500 pregnancies in the UK (Bagshawe, 1969). Molar tissue remaining after evacuation of the uterus usually spontaneously resolves. However, in 8% of cases this does not occur and the remaining tropho- blastic tumour develops into invasive mole or the highly malignant choriocarcinoma (Bagshawe et al, 1986). Beta-human chorionic gonadotrophin (B-HCG) is produced by trophoblastic tissue and can be used as a sensitive marker in the follow-up after molar pregnancy so that these sequelae can be detected at an early stage (Bagshawe et al, 1973). With current cytotoxic drugs, the great majority of patients with invasive mole or choriocarcinoma can be cured (Newlands et al, 1986). However, a small proportion of cases do relapse after apparently successful chemotherapy. These again can be detected by the use of B-HCG follow-up. Ultrasound is a modality that has been applied to the diagnosis of hydatidiform mole (MacVicar & Donald, 1963; Gottesfield et al, 1967; Leopold, 1971). Woo et al (1985) suggested that ultrasound could be used in moni- toring cases of invasive mole and choriocarcinoma as a guide to the need for further treatment or hysterectomy. However, the appearances of the uterus after the cyto- toxic chemotherapy of gestational trophoblastic tumours have not been clearly documented. This is an important area because residual abnormalities of the uterus after therapy may be misinterpreted as persistent tumour resulting in an unnecessary prolongation of toxic chemotherapy. This study describes the appear- ances of the uterus and ovaries after apparently successful therapy of invasive mole and gestational choriocarcinoma, and correlates the findings with relapse of the disease. Patients and methods |
| Databáze: | OpenAIRE |
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