Gestational trophoblastic tumor with liver metastatsis after misoprostol abortion

Background Early elective medical abortion is performed frequently in different countries of the world. Serious complications like gestational trophoblastic neoplasia (GTN) are uncommon and mostly nonmetastatic. High risk metastatic GTN following medical abortion is a rare event which may occur coin...

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Bibliographic Details
Published in:Archives of gynecology and obstetrics 2009-04, Vol.279 (4), p.587-590
Main Authors: Mousavi, S. A., Behnamfar, F.
Format: Article
Language:English
Subjects:
Abortion
Case Report
Endocrinology
Gynecology
Human Genetics
Medicine
Medicine & Public Health
Metastasis
Obstetrics/Perinatology/Midwifery
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Summary:Background Early elective medical abortion is performed frequently in different countries of the world. Serious complications like gestational trophoblastic neoplasia (GTN) are uncommon and mostly nonmetastatic. High risk metastatic GTN following medical abortion is a rare event which may occur coincidentally. Case A 26 year-old-woman, gravida 2 para 1, 6 weeks after misoprostol abortion presented with sever nausea, vomiting, and right upper abdominal pain. Human chorionic gonadotropin (hCG) level was 2,500,000 mIU/ml and metastatic work up revealed multiple liver metastases. She totally received nine cycles of EMA-CO (ethoposide- methotrexate- actinomycin- cyclophosphamide, vincristine) regimen for treatment and consolidation. Six months after treatment she is in complete remission. Conclusion Follow up of patients after medical abortion by means of single serum hCG measurement is highly recommended for early diagnosis of complications including gestational trophoblastic tumor. EMA-CO regimen seems to be an effective and safe treatment for liver metastatic gestational trophoblastic neoplasia.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-008-0756-7