PDF(Pubmed)
Abstract：
BACKGROUND: Trophoblastic neoplasms are often associated with pregnancy, and nongestational trophoblastic neoplasms are extremely rare. Nongestational ovarian choriocarcinoma (NGCO) is a highly aggressive germ cell-derived tumor frequently presenting with early hematogenous metastasis.
METHODS: Herein, we report a case of a 28-year-old unmarried woman with regular menstruation who experienced vaginal bleeding 1 week after her last menstrual cycle. Doppler ultrasound revealed bilateral adnexal masses and elevated serum human chorionic gonadotropin (hCG) levels. The patient was initially misdiagnosed as presenting an ectopic pregnancy.
METHODS: The final pathology confirmed an International Federation of Gynecology and Obstetrics stage IA NGCO with bilateral mature teratoma of the ovary. This is an extraordinary instance of ovarian choriocarcinoma which emerged without any prior gestation, and the patient\'s lack of a history of pregnancy made the diagnosis ignored.
METHODS: After initial surgery and 1 cycle of bleomycin, etoposide, and cisplatin (BEP) chemotherapy, a laparoscopic fertility-preserving comprehensive staging surgery was performed. Two cycles of chemotherapy with BEP were administered as supplemental therapy postsurgery, and leuprorelin was administered to protect ovarian function.
RESULTS: Menstruation resumed 4 months after chemotherapy completion, and tumor indicators were within the normal range. No signs of recurrence were observed at the 36-month follow-up.
CONCLUSIONS: NGCO should be considered if a female patient exhibits irregular vaginal bleeding and masses in the adnexal area. The present case and our literature review also highlighted that fertility-sparing surgery and multidrug chemotherapy are effective methods for treating NGCO.
METHODS: Herein, we report a case of a 28-year-old unmarried woman with regular menstruation who experienced vaginal bleeding 1 week after her last menstrual cycle. Doppler ultrasound revealed bilateral adnexal masses and elevated serum human chorionic gonadotropin (hCG) levels. The patient was initially misdiagnosed as presenting an ectopic pregnancy.
METHODS: The final pathology confirmed an International Federation of Gynecology and Obstetrics stage IA NGCO with bilateral mature teratoma of the ovary. This is an extraordinary instance of ovarian choriocarcinoma which emerged without any prior gestation, and the patient\'s lack of a history of pregnancy made the diagnosis ignored.
METHODS: After initial surgery and 1 cycle of bleomycin, etoposide, and cisplatin (BEP) chemotherapy, a laparoscopic fertility-preserving comprehensive staging surgery was performed. Two cycles of chemotherapy with BEP were administered as supplemental therapy postsurgery, and leuprorelin was administered to protect ovarian function.
RESULTS: Menstruation resumed 4 months after chemotherapy completion, and tumor indicators were within the normal range. No signs of recurrence were observed at the 36-month follow-up.
CONCLUSIONS: NGCO should be considered if a female patient exhibits irregular vaginal bleeding and masses in the adnexal area. The present case and our literature review also highlighted that fertility-sparing surgery and multidrug chemotherapy are effective methods for treating NGCO.
摘要：
背景：滋养细胞肿瘤通常与妊娠有关，非妊娠滋养细胞肿瘤极为罕见。非妊娠性卵巢绒毛膜癌（NGCO）是一种高度侵袭性的生殖细胞衍生肿瘤，经常表现为早期血行转移。
方法：这里，我们报道一例28岁未婚女性月经规律,在末次月经周期后1周出现阴道出血.多普勒超声显示双侧附件肿块和血清人绒毛膜促性腺激素（hCG）水平升高。患者最初被误诊为异位妊娠。
方法：最终病理证实国际妇产科联合会IANGCO期伴双侧卵巢成熟畸胎瘤。这是卵巢绒毛膜癌的一个非同寻常的例子，没有任何妊娠，而患者缺乏妊娠史，使得诊断被忽略。
方法：初次手术和1周期博来霉素后，依托泊苷,顺铂（BEP）化疗，进行了腹腔镜保留生育功能的综合分期手术.术后给予两个周期的BEP化疗作为补充治疗，亮丙瑞林用于保护卵巢功能。
结果：化疗结束后4个月月经恢复，肿瘤指标均在正常范围内。在36个月的随访中没有观察到复发的迹象。
结论：如果女性患者出现不规则阴道出血和附件区域肿块，应考虑使用NGCO。本病例和我们的文献综述还强调，保留生育力的手术和多药化疗是治疗NGCO的有效方法。
方法：这里，我们报道一例28岁未婚女性月经规律,在末次月经周期后1周出现阴道出血.多普勒超声显示双侧附件肿块和血清人绒毛膜促性腺激素（hCG）水平升高。患者最初被误诊为异位妊娠。
方法：最终病理证实国际妇产科联合会IANGCO期伴双侧卵巢成熟畸胎瘤。这是卵巢绒毛膜癌的一个非同寻常的例子，没有任何妊娠，而患者缺乏妊娠史，使得诊断被忽略。
方法：初次手术和1周期博来霉素后，依托泊苷,顺铂（BEP）化疗，进行了腹腔镜保留生育功能的综合分期手术.术后给予两个周期的BEP化疗作为补充治疗，亮丙瑞林用于保护卵巢功能。
结果：化疗结束后4个月月经恢复，肿瘤指标均在正常范围内。在36个月的随访中没有观察到复发的迹象。
结论：如果女性患者出现不规则阴道出血和附件区域肿块，应考虑使用NGCO。本病例和我们的文献综述还强调，保留生育力的手术和多药化疗是治疗NGCO的有效方法。
