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Cesarean scar gestational trophoblastic disease: two case reports

  • Ge-Er Zhang1
  • Shu-Ping Cai1
  • Zi-Min Pan1,*,

1Department of Obstetrics and Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou ,China

DOI: 10.12892/ejgo4044.2018 Vol.39,Issue 3,June 2018 pp.500-502

Published: 10 June 2018

*Corresponding Author(s): Zi-Min Pan E-mail: zju_panzimin@outlook.com

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Abstract

Cesarean scar gestational trophoblastic disease (GTD) is very rare. With relaxation of China’s fertility policy, the number of cases has increased. The authors admitted two patients with hydatidiform moles in 2005; ultrasound indicated a nidus located in a previous cesareanscar. Both patients underwent uterine artery embolization (UAE) followed by suction curettage or hysteroscopy and were subsequently diagnosed with cesarean scar gestational trophoblastic neoplasms, and chemotherapy was administered. The prognosis of both patients is good. The authors found that the trophoblastic cells on cesarean scar were more likely to cause myometrium infiltration and result in a high risk of bleeding. Ultrasound, UAE, and hysteroscopy play important roles in its diagnosis and treatment. When a cesarean scar gestational trophoblastic neoplasm is considered, chemotherapy should be promptly administered .

Keywords

Cesarean section; Drug therapy; Gestational trophoblastic disease; Pregnancy; Neoplasms.

Cite and Share

Ge-Er Zhang,Shu-Ping Cai,Zi-Min Pan. Cesarean scar gestational trophoblastic disease: two case reports. European Journal of Gynaecological Oncology. 2018. 39(3);500-502.

URL:

https://www.ejgo.net/articles/10.12892/ejgo4044.2018

References

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[2] Rotas. M.A., Haberman S., Levgur M.: “Cesarean scar ectopic pregnancies - Etiology, diagnosis, and management”. Obstet. Gynecol., 2006, 107, 1373.

[3] Jauniaux E.: “Ultrasound diagnosis and follow-up of gestational trophoblastic disease”. Ultrasound Obstet. Gynecol., 1998, 11, 367.

[4] Fowler D.J., Lindsay I., Seckl M.J., Sebire N.J.: “Routine pre-evacuation ultrasound diagnosis of hydatidiform mole: experience of more than 1000 cases from a regional referral center”. Ultrasound Obstet. Gynecol., 2006, 27, 56.

[5] Kirk E., Papageorghiou A.T., Condous G., Bottomley C., Bourne T.: “The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole”. Ultrasound Obstet. Gynecol., 2007, 29, 70.

[6] Armstrong V., Hansen W.F., Van Voorhis B.J., Syrop C.H.: “Detection of cesarean scars by transvaginal ultrasound”. Obstet. Gynecol., 2003, 101, 61.

[7] Seow K.M., Hwang J.L., Tsai Y.L.: “Ultrasound diagnosis of a pregnancy in a Cesarean section scar”. Ultrasound Obstet. Gynecol., 2001, 18, 547.

[8] Zhuang Y.L., Huang L.L.: “Uterine artery embolization compared with methotrexate for the management of pregnancy implanted within a cesarean scar”. Am. J. Obstet. Gynecol., 2009, 201, 3.

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