Gynecology Oncology
Soheila Aminimoghaddam; Zahra Vahedpoor; Shabnam Bozorgzadeh
Volume 8, Issue 4 , July and August 2023, , Pages 417-421
Abstract
Hereditary non polyposis colorectal cancer (HNPCC) also known as Lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers, it predisposes patients to extracolonic cancers. Despite several extracolonic cancers have been reported on LS, we found a new face of it. A 43-year-old ...
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Hereditary non polyposis colorectal cancer (HNPCC) also known as Lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers, it predisposes patients to extracolonic cancers. Despite several extracolonic cancers have been reported on LS, we found a new face of it. A 43-year-old G2L2 patient with chief complaint of abnormal uterine bleeding. Her endometrium biopsy showed clear cell carcinoma, and the necessary work-ups have been done. But the patient's family history demonstrated HNPCC based on the Amsterdam 2 criteria. After some years, the patient presented to our hospital for fever, shivering and abdominal LUQ pain. Spiral CT scan showed a solid cyst with heterogeneous enhancement in the spleen, and hepatosplenomegaly. In this paper, another case with endometrial cancer as a sentinel cancer of LS is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider LS.
Gynecology Oncology
Haleh Ayatollahi; Samira Jahangard
Volume 6, Issue 1 , January 2021, , Pages 35-41
Abstract
Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, ...
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Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, which was successfully treated with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen.Case presentation: A 34-year-old woman was presented with vaginal bleeding, dyspnea, and moderate abdominal pain. She had a menstrual delay of about two weeks. She had a primary β-human chorionic gonadotropin (β-hCG) of 132 600 mIU/mL. On lung computed tomography (CT) scan images, a metastatic lesion with a size of 68×50 mm was observed in the lower lobe of the left lung. The patient underwent dilation and curettage (D&C) that revealed choriocarcinoma. Brain magnetic resonance imaging (MRI) also showed a small metastatic mass with a size of 7 mm at the right occipital lobe. The patient was started on chemotherapy with an EMACO regimen. The patient’s β-hCG decreased continuously, and it was negative after the fourth cycle and six sessions of radiotherapy. It also remained negative six months after chemotherapy. The final examinations of the patient had no abnormal findings. Conclusion: Brain metastasis may be relatively asymptomatic in patients with choriocarcinoma, and it should be considered by physicians, even when there are no neurological symptoms. Also, the EMACO regimen seems to be an appropriate regimen for the treatment of metastatic choriocarcinoma.
