جستجوی مقالات مرتبط با کلیدواژه « Choriocarcinoma » در نشریات گروه « پزشکی »

Choriocarcinoma usually occurs in the uterine body. Non-gestational choriocarcinoma is an extremely rare malignant tumor with a poor prognosis and is difficult to distinguish from gestational choriocarcinoma. In this case report, we describe a case of pure non-gestational choriocarcinoma. A 35-year-old woman was referred to our academic hospital with a pathology report of non-gestational choriocarcinoma of right ovarian cystectomy. Since the diagnosis did not coordinate with the patient's symptoms, PCR amplifying, and genomic DNA were performed. Finally, the diagnosis of pure non-gestational choriocarcinoma was confirmed. In follow-up, lung and brain metastasis was determined. Brain radiotherapy and BEP regimen chemotherapy were prescribed. However, the response was not appropriate, so she is currently undergoing palliative chemotherapy. Stage IV primary pure ovarian choriocarcinoma is a very aggressive tumor. Regardless of the nature of the tumor, the response to the treatment may not be good. Indeed the treatment of each case should be individualized.

Gestational trophoblastic disease (GTD) is a general term that includes several types of pathologically different diseases, which range from hydatidiform mole to choriocarcinoma. Early differentiation of these types is important to determine treatment strategy and prognosis.

Genetic markers such as TP53 and HER-2/neu expression are recently shown to have diagnostic and prognostic values. The aim of this study was to evaluate its significance.

We enrolled 62 patients diagnosed with GTD referred to Imam Hossein Hospital in Tehran, Iran between 2012 and 2017. Endometrial pathologic specimens were stained, using the immunohistochemistry (IHC) method for the expression of TP53 and HER-2/neu genes. Expression levels determined by IHC were compared between final pathologic diagnoses, using one-way ANOVA test (analysis of variances), which detects significant differences between the means of 3 or more independent groups.

Out of 62 participants, 32 and 24 cases were diagnosed as partial and complete hydatidiform mole, respectively. Four cases had invasive hydatidiform mole and only 2 cases were diagnosed as choriocarcinoma. Analysis using ANOVA demonstrated that expression levels of both TP53 and HER-2/neu genes are significantly higher among patients with invasive form and choriocarcinoma compared with non-invasive hydatidiform mole (P < 0.05 for both genes). The receiver operating characteristic (ROC) curve for each gene showed that more than 55% positive staining for the TP53 gene can differentiate non-invasive hydatidiform mole from invasive form and choriocarcinoma with 100% sensitivity, and 92.9% specificity.

TP53 expression might serve as a potential diagnostic aid to differentiate benign and malignant GTDs and a future target for adjusting treatment based on the expression levels.

Primary mediastinal germ cell tumors accounts for about 3%-15% of the mediastinal malignancies. Nonseminomatous tumors make a small percentage of germ cell tumors. Treatment of mediastinal choriocarcinoma includes initial systemic chemotherapy, followed by complete resection of all residual tumors. However, patients with nonseminomatous tumors have very poor prognosis.

Choriocarcinoma is a rare and malignant tumor, which may present during or following any type of pregnancy. This tumor often demonstrates rapid hematogenous spread to multiple organs and is associated with high levels of human chorionic gonadotropin (HCG) and a good response to chemotherapy. Herein, we introduced a case of metastatic choriocarcinoma who failed to response to conventional therapies.

A 22-year-old woman referred with vaginal bleeding. The evaluations revealed that she had a metastatic choriocarcinoma that failed to response to conventional therapies. Continuation of chemotherapy was not possible due to the development of neutropenia. Interestingly, the patient achieved a complete remission spontaneously without receiving further treatment. During the follow-up period, when the patient should not become pregnant, she became pregnant and had no problems during the pregnancy.

Gestational trophoblastic neoplasia is a rare disease. The majority of women suffering from this disease can be cured and their reproductive function could be preserved through the utilization of sensitive quantitation assay for human chorionic gonadotropin (β-hCG) and highly effective chemotherapy.

Cesarean scar pregnancy is an ectopic pregnancy implanted in the myometrium at the site of a previous cesarean section scar and is the rarest kind of ectopic pregnancy. The present study present a case of choriocarcinoma (CC) in the cesarean scar. The clinical course, findings, and treatment plan are discussed.

Case report:

 A 41-years old multi-gravid woman with a history of one previous cesarean section and three subsequent abortions was admitted to the hospital. She suffered from an unknown abnormal vaginal bleeding for two months. Β-HCG titer was 1,000 IU/L and the report of sonography showed no gestational sac. Accordingly, the patient was diagnosed with ectopic pregnancy in the cesarean scar site and, therefore, weekly usage of methotrexate was prescribed for her. Since she did not respond to the treatment, she was referred to our department in the Faculty of Medicine. The evaluation showed mass invasion through the entire uterine wall. The uterus preservation was not possible, therefore, total hysterectomy was performed. The pathology report confirmed CC in the cesarean scar.

Based on previous studies, as the number of cesarean sections increases, the possibility of complications rises, as well.  Cesarean scars implantation of CC is one of the rare complications of caesarean section. The probability of a gestational trophoblastic disease should be considered in any woman during her pregnancy. Early detection and proper management of the complications can result in a decrease in morbidity and mortality.

Choriocarcinoma is a rare neoplasm, which is commonly treated with chemotherapy. However, in some cases, it is managed by surgical intervention to save the patient’s life. Here, we present a rare case of uterine rupture associated with choriocarcinoma in a patient with COVID-19 infection.

We present the case of a 34-year-old woman with choriocarcinoma, complicated by uterine rupture after the first course of chemotherapy, and concurrent COVID-19 infection. The patient underwent an emergency hysterectomy and survived after transferring to an isolated intensive care unit room.

During the COVID-19 pandemic, it is suggested to perform optimal surgery in the emergency setting to prevent further complications.

Choriocarcinoma spheroids, as acceptable three-dimensional (3D) models of the embryo, vary in the number of incorporated cells based on the procedures of production. Since the secretion of emitted signals from spheroids can modulate endometrial confrontation responses, improving a high throughput standard assay is precisely demanding for normalizing the characteristics of spheroids based on cellular enumeration.

Spheroids derived from the suspension culture of the BeWo cell line were dimensionally categorized into three groups with sizes of 50, 100, and 200 µm in diameters. The volume of each spheroid was determined according to 4/3πr3 formula and MTT and neutral red uptake (NRU) assays were applied as conventional and modified procedures. Furthermore, the categorized groups of spheroids were enzymatically dissociated and stained by the Trypan blue dye to precisely enumerate the number of incorporated cells based on volume alterations.

The absorbance of spheroids in modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients with volume alterations. Similarly, modified MTT and NRU procedures with respect to the conventional ones resulted in higher correlation coefficients between the cells numeration and volume alterations. Finally, the sensitivity of modified MTT assay was higher than modified NRU assay regarding accurately estimating the number of incorporated cells per spheroid.

In general, the modification of MTT and NRU procedures can amplify the potential of both assays to enumerate the cell number of 3D aggregates. Exclusively, the modification of MTT assay brought it as an ideal high throughput assay with high sensitivity to screen the cell number of spheroids with a diameter of 200 µm and less.