Gestational choriocarcinoma presenting as hemothorax.

Choriocarcinoma include a spectrum of chorionic neoplasms that may be gestational or non-gestational. By virtue of their high vascularity and affinity of trophoblast for blood vessels, metastases often occur early, and the most common site of such metastases is the lung. Metastatic pleural effusions from choriocarcinoma are infrequent. Pleural seeding usually results from extension of a sub-pleural peripheral nodule. We describe a case of gestational choriocarcinoma whose clinical presentation was medical like hemothorax as in our case rather than gynecologic.

Choriocarcinoma - a rare association with squamous cell carcinoma of esophagus.

Extragenital choriocarcinoma involving the gastrointestinal tract is rare. We report a 60-year-old woman with squamous cell carcinoma of esophagus with a choriocarcinomatous focus. She was palliated with chemotherapy and an endoprosthesis.

[Term delivery following successful treatment of choriocarcinoma with brain metastases a case report]

Cerebral metastases from choriocarcinoma are poor prognostic indicator of outcome in both the World Health Organization and FIGO classification systems. Although gestational trophoblastic neoplasia has become the most curable gynecological malignancy, failure rate among 'high-risk' patients is still high despite the use of aggressive multidrug regimens. A 27 year old woman [G4P2Ab1] presented with hemiplegia due to brain metastases of choriocarcinoma one year after spontaneous abortion. She underwent craniotomy and was treated with nine courses of multiple agent etoposide, methotrexate, actinomycin-etoposide and cisplatinum [EMA-EP] regimen combined with whole brain irradiation. She delivered a term healthy child two years after termination of treatment. Multiagent EMA-EP chemotherapy and whole brain irradiation with craniotomy in selected patients preserves fertility and may improve a patient overall prognosis

Testicular choriocarcinoma with gastric metastasis presenting as hematemesis.

We report a 28-year-old man who presented with hematemesis due to choricarcinoma of testis metastatic to the stomach. Gastroscopy showed a polypoidal lesion. Testicular wedge biopsy confirmed mixed germ cell tumor, the choriocarcinomatous portion alone getting metastasized to the stomach. He was initiated on chemotherapy with actinomycin-D, etoposide and methotrexate, but died due to multiple metastases to the lung and brain.

[ case report of metastatic choriocarcinoma to jejunum with severe lower GI bleeding]

A 33-year-old female presented with intermittent abdominal pain and severe attacks of lower gastrointestinal [GI] bleeding since 2 weeks. She has had history of irregular menses in last 3 months. In the labeled RBC-Scan study, the bleeding site was detected in left upper quadrant [LUQ]. In surgery, a tumor with the diameter of 2x1cm in a 65 cm distance of ligament of Trietz was detected. In pathological assessment jejunal metstatic choriocarcinoma was reported. Generally, choriocarcinoma is very rare among the intestinal metastatic tumors, including less than 5% of these tumors. Its presentation is acute lower GI bleeding and organ rupture, especially splenic rupture. These tumors will respond appropriately to the treatment in initial stages. Chemotherapy is the treatment of choice in these tumors

Gestational trophoblastic diseases [GTD]: Curable or fatal diseases? A single institution experience

The aim of this study was to define the treatment results and causes of failure including treatment toxicity in 48 patients with gestational trophoblastic diseases [GTD]. The clinical records of the patients were reviewed with regards to presentation, investigation, management and outcome. Thirty-nine patients received chemotherapy as they maintained high serum BHCG after suction and termination of molar pregnancy and other nine patients showed a progressive decline within one week and kept under follow up. Due to the relatively high toxicity of 4-day methotrexate outpatient schedule, it was recommended to shift to 1-day IV basis schedule. In case of extensive pulmonary metastasis, initial co-management with pulmonologist and ICU will be very beneficial to prevent ERD starting very carefully

Prognosis of gestational choriocarcinoma at Khyber teaching hospital Peshawar

Choriocarcinoma is a highly malignant tumour which originates in developing trophoblast of pregnancy, most commonly following molar pregnancy. It is a potentially fatal disease, but current management protocols have turned the prognosis highly favourable. This study was done on patients with gestational choriocarcinoma presenting to Gynae-B unit of Khyber Teaching Hospital Peshawar, between May, 1996 to December, 1997, diagnosed on the basis of clinical course and elevated level of HCG. Metastatic evaluation of the disease was done to assign different risk groups to the patients before selecting appropriate chemotherapy regimen for each patient. Results of the therapy were monitored by serial estimation of HCG levels. During this period 5 patients of choriocarcinoma were treated. In 2 [40%] cases choriocarcinoma developed after molar pregnancy whereas in 3 [60%] cases antecedent pregnancy resulted in spontaneous abortion. Four [80%] patients were from poor socioeconomic class, 3 [60%] were above 39 years of age and 4 [80%] were multiparous. Two patients [40%] were medium risk and 3 [60%] were high risk cases. There was no patient with low risk disease. EMA-CO [Etoposide, Methotrexate, Actinomycin-D, Cytocine, Oncovine] regimen was administered to all patients. Maximum number of cycles of chemotherapy given was 8. Only one patient developed drug resistance. Overall cure rate was 80% [4 patients survived out of 5 at two years follow-up]. Prognosis of gestational choriocarcinoma is favourable provided the appropriate therapy is administered early in the course of disease. Provision of free medical care should be considered for these patients to save their lives

Cariocarcinoma postparto normal: un caso clínico / Choriocarcinoma after normal delivery: a clinical case

El término neoplasia trofoblástica gestacional contempla al coriocarcinoma y a otros tumores del trofoblasto. La incidencia de coriocarcinoma en Latioamérica y Europa es de 0,2 casos por 10.000 embarazos. Esta grave patología puede ser precedida por diversos cuadros obstétricos. La principal sintomatología es la hemorragia transvaginal, espontánea o asociada a procedimientos invasivos. Se asocia a un aumento significativo de la hormona gonadotrófica coriónica. El diagnóstico se confirma con la histología. La quimioterapia es la principal herramienta terapéutica. A propósito de un caso clínico, se analizan las características y tratamiento del coriocarcinoma

Coriocarcinoma posparto: comunicación de un caso / Postpartum coriocarcinoma: communication of a case

Se presenta el caso de una paciente de 21 años, II gesta, con un coriocarcinoma posparto que cursó con hemorragia vaginal y metástasis pulmonar y epiplón. El tratamiento fue histerectomía con quimioterapia (metotrexate, ácido folínico, actinomicina D). Las metástasis pulmonares permanecieron visibles por largo tiempo en la radialogía de torax pero las cifras de gonadotropinas coriónicas humanas fueron negativas. Actualmente la paciente permanece con criterios de curación

Influência de corticóide, na Doença de Chagas crônica, administrado em virtude de afecçöes associadas / Corticosteroid influence on chronic Trypanosoma cruzi infected patients, administered by virtue of associated diseases

Individuos acometidos de doença de Chagas em fase crônica foram tratados com corticóide, em virtude de afecçöes concomitantes. A fim de avaliar repercussöes sobre a infecçäo devida ao Trypanosoma cruzi, houve adoçäo de procedimentos de várias ordens, representados por métodos referentes à parasitose, exames inespecíficos e subsídios clínico, eletrocardiográfico e radiológico, tendo também sido mantido, para comparaçäo, grupo controle. Através do xenodiagnóstico ficou constatada a acentuaçäo da parasitemia, diretamente relacionada com a dose de corticóide, sem influência na evoluçäo da enfermidade parasitária, pelo menos durante o período no qual ocorreu a investigaçäo

Gestational choriocarcinoma of the fallopian tube--a case report.

Gestational Choriocarcinoma occurring in a female aged 20 years is being reported following ectopic tubal pregnancy. The case responded well to the conventional Chemotherapy regimen.

Coriocarcinoma de ovario / Choriocarcinoma of the ovary

Se presentó un caso de coriocarcinoma ovárico en una mujer de 24 años de edad sin antecedentes de gestaciones. Clínicamente la enfermedad debutó con un cuadro respiratorio y radilógico con características de tuberculosis pulmonar. Por la presencia de una masa tumoral del anexo derecho la paciente fue operada encontrándose un tumor de ovario diagnosticado histológicamente como coriocarcinoma, con implantes neoplásicos en mesosalpinx y pared del cuello uterino. La paciente recibió tratamiento quimioterápico y sobrevivió cuatro años. Se discute la posibilidad de que la neoplasia haya sido primaria o metastásica a ovario

Coriocarcinoma gestacional en un embarazo tubario: caso clínico / Gestational choriocarcinoma in a tubal pregnancy: clinical case

Se reporta el caso de un coriocarcinoma gestacional en un embarazo ectópico tubario. Se trató con salpingectomía unilateral y quimioterapia con metotrexato consiguiénose curación. A la fecha se completa un seguimiento de dos años sin evidencia de enfermedad