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Conservative surgical treatment of an isolated uterine body choriocarcinoma under transient occlusion of uterine arteries

  • Sang-Hun Lee1
  • Jae Young Kwack1
  • Yong-Soon Kwon1,*,

1Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Ulsan University Hospital, Ulsan, Republic of Korea

DOI: 10.12892/ejgo4077.2018 Vol.39,Issue 3,June 2018 pp.503-506

Published: 10 June 2018

*Corresponding Author(s): Yong-Soon Kwon E-mail: kbongchun@hanmail.net

Abstract

In patients with choriocarcinoma of the uterine body who want to preserve fertility, it is inevitable to perform uterus conserving surgery with safe surgical techniques and to obtain an efficient clinical outcome of survival and pregnancy. A 30-year-old G1 P0 patient was referred to the present department due to treatment failure of abnormal intrauterine pregnancy after endometrial curettage. Under the clinical impression of gestational trophoblastic disease (GTN) localized in the posterior uterine body, the patient underwent wide wedge resection of uterine wall along with securing safe margins under transient occlusion of uterine arteries (TOUA). After resection and uteroplasty was performed, the pathology report revealed the diagnosis of choriocarcinoma; hence, the patient received three cycles of adjuvant chemotherapy with the EMA-CO regimen. During 12 months after completing chemotherapy treatment, the patient has been doing well without recurrence.

Keywords

Conservative surgery; Choriocarcinoma; Uterine body.

Cite and Share

Sang-Hun Lee,Jae Young Kwack,Yong-Soon Kwon. Conservative surgical treatment of an isolated uterine body choriocarcinoma under transient occlusion of uterine arteries. European Journal of Gynaecological Oncology. 2018. 39(3);503-506.

References

[1] Kwon Y.S., Roh H.J., Ahn J.W., Lee S.H., Im K.S..: “Transient occlusion of uterine arteries in laparoscopic uterine surgery”. JSLS, 2015, 19, e2014 00189.

[2] Lurain J.R.: “Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational tro phoblastic disease, and management of hydatidiform mole”. Am. J. Obstet. Gynecol., 2010, 203, 531.

[3] Dhillon T., Palmieri C., Sebire N.J., Lindsay I., Newlands E.S., Schmid P. et al.: “Value of whole body 18FDG-PET to identify the active site of gestational trophoblastic neoplasia”. J. Reprod. Med., 2006, 51, 879.

[4] Dekel A., van Iddekinge B., Isaacson C., Dicker D., Feldberg D., Goldman J.: “Primary choriocarcinoma of the fallopian tube. Report of a case with survival and postoperative delivery. Review of the literature”. Obstet. Gynecol. Surv., 1986, 41, 142.

[5] Lurain J.R., Singh D.K., Schink J.C.: “Role of surgery in the management of high-risk gestational trophoblastic neoplasia”. J. Reprod. Med., 2006, 51, 773.

[6] Muto M.G., Lage J.M., Berkowitz R.S., Goldstein D.P., Bernstein M.R.: “Gestational trophoblastic disease of the fallopian tube”. J. Reprod. Med., 1991, 36, 57.

[7] Rotas M., Khulpateea N., Binder D.: “Gestational choriocarcinoma arising from a cornual ectopic pregnancy: a case report and review of the literature”. Arch. Gynecol. Obstet., 2007, 276, 645.

[8] Kim T.H., Lee H.H., Kwak J.J.: “Conservative management of abnormally invasive placenta: choriocarcinoma with uterine arteriovenous fistula from remnant invasive placenta”. Acta Obstet. Gynecol. Scand., 2013, 92, 989.

[9] Kwon Y.S., Roh H.J., Ahn J.W., Lee S.H., Im K.S.: “Conservative adenomyomectomy with transient occlusion of uterine arteries for diffuse uterine adenomyosis”. J. Obstet. Gynaecol. Res., 2015, 41, 938.

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