Publication: Gestational Trophoblastic Neoplasia with Gum Metastasis: A Case Study and Literature Review
Issued Date
2020-01-01
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ISSN
16626575
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2-s2.0-85085308099
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Mahidol University
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SCOPUS
Bibliographic Citation
Case Reports in Oncology. (2020), 485-490
Suggested Citation
Nida Jareemit, Mongkol Benjapibal Gestational Trophoblastic Neoplasia with Gum Metastasis: A Case Study and Literature Review. Case Reports in Oncology. (2020), 485-490. doi:10.1159/000506329 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/56288
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Title
Gestational Trophoblastic Neoplasia with Gum Metastasis: A Case Study and Literature Review
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Abstract
© 2020 The Author(s). Published by S. Karger AG, Basel. Gestational trophoblastic neoplasia (GTN) is an uncommon group of pregnancy-related malignancies. Delayed diagnosis is a prognostic factor for worse outcome. GTN is even harder to diagnose if the site of metastasis is uncommon. The reported case is a 27-year-old G<sub>2</sub>P<sub>1</sub>A<sub>1</sub> woman who presented to our center with acute transient generalized tonic-clonic seizure. She had developed hemoptysis for the 2 preceding weeks, which had been treated as pneumonia. She had then noticed multiple gum lesions and vaginal spotting 1 week before her presentation. Her serum β-human chorionic gonadotropin level was 77,474 IU/L without evidence of pregnancy. She was diagnosed with GTN with lung, brain, and gum metastases. The patient was staged as IV with a World Health Organization prognostic score of 14. Etoposide, methotrexate, actinomycin D alternating with cyclophosphamide, and vincristine weekly (EMACO) were given. The gum lesions disappeared after 2 cycles of the multiagent chemotherapy, and complete remission was achieved after 8 cycles. This case study will increase awareness of uncommon metastatic sites of GTN. Any associated vaginal bleeding should be considered a clue to metastatic GTN.