Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review

Orphanet Journal of Rare Diseases

Junjun Yang¹  Fengzhi Feng¹  Xiaoyu Wang¹  Xirun Wan¹  Jun Zhao¹  Tong Ren¹  Yang Xiang¹ 

[1] Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, National Clinical Research Center for Obstetric and Gynecologic Diseases, Shuaifuyuan No. 1, Dongcheng District, 100730, Beijing, China;

关键词: Cervical choriocarcinoma;    Clinical features;    Diagnosis;    Gestational trophoblastic neoplasia;    Treatment;   

DOI  :  10.1186/s13023-021-02111-w

来源: Springer

【 摘 要 】

BackgroundPrimary cervical gestational trophoblastic neoplasias (GTNs) are extremely rare ectopic GTNs. Such lesions are difficult to diagnose clinically because of their rarity, with abnormal vaginal bleeding of a non-specific cause being the most common symptom. To that end, this retrospective study aimed to identify the clinical characteristics of cervical GTN and to explore diagnostic and therapeutic strategies.ResultsThirteen patients diagnosed with primary cervical GTN at the Department of Gynecology, Peking Union Medical College Hospital, Beijing, China, between June 1, 1988 and May 31, 2020 were included in the study. All patients had irregular vaginal bleeding, including six who presented with massive bleeding. Seven patients (53.8%) were initially misdiagnosed with a cervical pregnancy. All patients received chemotherapy; 11 (84.6%) also underwent hysterectomy because of chemoresistant lesions or uncontrolled bleeding. All patients achieved complete remission; however, two women (15.4%) experienced a relapse during the median follow-up period of 35 months. A comprehensive review of English-language literature published between 1980 and 2020 identified 22 case reports encompassing 27 patients. The definitive diagnosis was achieved via pathology in 26 of them (96.3%), and hysterectomy was performed in 21 (77.8%).ConclusionsOwing to its rarity and nonspecific symptoms, the diagnosis of primary cervical GTN is challenging and often relies on pathology. The combination of chemotherapy and hysterectomy is the main therapeutic strategy for this disease.

【 授权许可】

CC BY