Choriocarcinoma in mother and child. Case report.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to F Flam.
Explore the source record for details and available documents.
Persistently elevated levels of serum human chorionic gonadotropin (hCG) in women call for a tumor investigation, if pregnancy can be ruled out. We present a case of increased hCG concentrations for 1 1/2 years. Radiolabelled antibody directed against the hCG molecule indicated the source of production to be a choriocarcinoma. The patient was cured by multiagent chemotherapy.
Experience gathered during the last 20 years in the treatment of gestational trophoblastic neoplasia (GTN) is presented. Fifty-eight cases were treated at the Karolinska Hospital during the period of 1966-86. This number accounts for approximately 50% of the cases in Sweden during this period of time. Thirty-four patients developed their malignancy after a molar pregnancy. Thirty-three patients were nonmetastatic and of the 25 metastatic cases, 6 patients were staged to a high-risk group. Chemotherapy was given to all patients except one who had a primary choriocarcinoma in an ectopic pregnancy. Surgery was performed in elective cases or when chemotherapy failed. Surgical procedures were also performed in a few emergency situations. Since 1978 all patients were started on methotrexate--folinic acid ad modum Goldstein. When this medication failed, either the CHAMOMA (vincristine, methotrexate--folinic acid, actinomycin D, melphalan, adriamycin) or later the EMA/CA (etoposide, methotrexate--folinic acid, actinomycin D, cyclophosphamide, adriamycin) regimen ad modum Bagshawe was given. An overall remission rate of 96.5% was achieved. The minimum period of follow-up was 2 years. The 2 patients who died (in 1966 and 1982) were referred to our department in a late stage. Five patients had a late recurrence and all but one were successfully treated.
The symptomatology of ovarian cancer was retrospectively reviewed in 362 patients. According to the stage at diagnosis, the disease was classified as early (stages IA-IIA) or advanced (stages IIB-IV). The most common initial symptoms were abdominal swelling and/or palpable tumour, pain and gastro-intestinal symptoms. The initial symptoms, however, were not necessarily those that prompted the patients to seek medical advice. Most were first seen by a gynecologist, which possibly explains the shortness of doctor's delay in the urbanized catchment region.
Multiple curettages in the follow-up of patients with hydatidiform mole are often performed in Sweden. Of 36 patients developing trophoblastic neoplasia after molar evacuation, 24 underwent one or more endometrial curettages. The objective was generally to verify a diagnosis of malignant disease. However, in only one patient was a histopathological proof of choriocarcinoma obtained. In 3 other patients, malignancy could not be ruled out. It is demonstrated that development of malignancy after hydatidiform mole is rarely proven by endometrial curettage.
Explore the source record for details and available documents.