ТЯЖКИЙ ПЕРЕБІГ ГЕСТАЦІЙНОЇ ТРОФОБЛАСТИЧНОЇ НЕОПЛАЗІЇ У МОЛОДОЇ ЖІНКИ З В'ЄТНАМУ ПІСЛЯ ПРИПИНЕННЯ ХІМІОТЕРАПІЇ: АНАЛІЗ КЛІНІЧНОГО ВИПАДКУ ТА ОГЛЯД ЛІТЕРАТУРИ

• Date: 2024
• Main Authors: VO, THANH NHAN, NGUYEN, PHUC NHON
• Format: Article
• Language: English
• Published: PH Akademperiodyka 2024
• Subjects: хоріокарцинома; поліхіміотерапія; схема EMA/CO багатопрофільний підхід
• Online Access: https://exp-oncology.com.ua/index.php/Exp/article/view/398
• Journal Title: Experimental Oncology

Choriocarcinoma is characterized as the most aggressive malignant alternation of gestational trophoblastic neoplasm; however, this illness is a curable malignancy. Although a rarity, this disease affects a female patient’s life and causes a fatal condition. Choriocarcinoma is a life-threatening disease since it is initially insidious and can rapidly lead to masive hemorrhage, even death. Choriocarcinoma should be suspected in childbearing-age women with the high-risk scores according to FIGO. The study aims to report a severe case of widespread metastatic choriocarcinoma to optimize the treatment with multiagent chemotherapy and a multidisciplinary cooperation at our center. A G1P0 20-year-old woman was referred to the hospital for suspicion of metastatic choriocarcinoma after self-stopping chemotherapy because of the COVID-19 pandemic. During hospitalization, the tumor metastasized and presented profuse intraabdominal hemorrhage. The patient underwent immediate surgical intervention to control bleeding, and a definitive diagnosis was accurately established by the histopathological examination. After surgery, the EMA/CO regimen was administered as the first line of treatment, despite the patient being in a coma and requiring a ventilator machine. After 6 cycles of the EMA/CO regimen, her serum β-hCG level decreased to 8 mUI/mL, however, her β-hCG concentration was not down to a negative value. Thus, the patient received paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE regimen) for complete remission following 2 cycles. The delays in choriocarcinoma treatment are prognostic factors for worse outcomes, whereas chemotherapy may be considered a suitable treatment even in a patient’s coma, thus improving a prognosis substantially.