Abstract:
Gestational trophoblastic neoplasia (GTN) with spinal metastasis is rare with few documented cases worldwide. Few studies have explored chemotherapy combined with radiotherapy in the treatment of such cases. However, because of its rarity, there is still no standardized treatment regimen. A 34-year-old Gravida 1 Para 0 (0010) was diagnosed with GTN with metastasis to the lumbosacral spine, resulting in conus medullaris syndrome with lumbar radiculopathy. She presented with a 14-month history of amenorrhea, left lower extremity pain, and urinary and bowel retention. On examination, there was a 10.0 × 7.0 cm lumbosacral mass and atrophy of the left lower extremity. Transvaginal ultrasound showed a cul de sac mass, and diluted β-human chorionic gonadotropin (β-hCG) titer was markedly elevated at more than 1000 000 mIU/mL. Magnetic resonance imaging (MRI) of the lumbosacral spine showed an ill-defined sacral mass measuring 13.3 × 11.5 × 6.3 cm with spinal canal, bone, muscle, and nerve root involvement. She was treated with 10 cycles of EMACO and palliative radiotherapy with 10 sessions of 30 Gy of external beam radiation therapy directed toward the lumbosacral mass. Repeat MRI showed a decrease in size of the mass to 6.6 × 8.2 × 4.1 cm with concurrent decrease in β-hCG to 1.30 mIU/ml, and resolution of leg pain and urinary and bowel symptoms. She was declared to be in remission 3 months after the last cycle of EMACO.
摘要:
患有脊柱转移的妊娠滋养细胞瘤(GTN)很少见,在全球范围内很少有文献记载。很少有研究探讨化疗联合放疗治疗此类病例。然而,因为它的稀有性,目前还没有标准化的治疗方案.一名34岁的Gravida1Para0(0010)被诊断为GTN并转移到腰骶椎,导致脊髓圆锥综合征合并腰椎神经根病。她有14个月的闭经史,左下肢疼痛,还有尿潴留.在检查中,左下肢有一个10.0×7.0cm的腰骶部肿块和萎缩。经阴道超声显示有死胡同肿块,稀释的β-人绒毛膜促性腺激素(β-hCG)滴度明显升高,超过1000000mIU/mL。腰骶椎的磁共振成像(MRI)显示,骶骨肿块不明确,大小为13.3×11.5×6.3cm,与椎管,骨头,肌肉,和神经根受累。她接受了10个周期的EMACO和姑息性放射治疗,并进行了10次30Gy的针对腰s肿块的外部束放射治疗。重复MRI显示肿块大小减少至6.6×8.2×4.1cm,同时β-hCG减少至1.30mIU/ml,和解决腿部疼痛和泌尿和肠道症状。在EMACO的最后一个周期后3个月,她被宣布处于缓解状态。