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Successful pregnancy after treatment of a cervical gestational trophoblastic neoplasia: a case report
Angelica A Chua1, Agnes L Soriano-Estrella
1Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines, Manila. jayannechuamd@yahoo.com
Background:
Primary gestational trophoblastic neoplasia of the uterine cervix is exceptionally rare, with fewer than 100 cases reported worldwide.
Case:
A 33-year-old, gravida 1, para 1, Filipino woman was admitted due to vaginal bleeding nearly 7 months after delivery of a full-term, stillborn infant. Transvaginal ultrasound revealed a heterogeneous, predominantly solid, vascular mass at the upper half of the cervix measuring 3.05 x 3.75 x 3.6 cm. Serum beta human chorionic gonadotropin (beta-hCG) on admission was 101,922.5 mIU/mL. She was initially treated with single-agent chemotherapy in the form of methotrexate. Rising levels of serum beta-hCG after the third cycle necessitated a shift to multiagent chemotherapy in the form of etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine. The patient achieved remission after 6 cycles and eventually achieved a successful pregnancy.
Conclusion:
Primary gestational trophoblastic neoplasia of the cervix can be treated successfully using chemotherapy.