Clinical and Management Challenges of Gestational Trophoblastic Neoplasia Involving the Cervix: A Case Report

Gestational Trophoblastic Neoplasia (GTN) involving the cervix is an uncommon and potentially life-threatening condition that poses significant diagnostic and therapeutic challenges. Early recognition and risk-adapted management are essential to achieve optimal outcomes. We report a 36-year-old woman with a prior history of molar pregnancy who presented with abnormal vaginal bleeding and systemic symptoms suggestive of malignancy. Laboratory evaluation revealed markedly elevated serum β-hCG levels, and imaging demonstrated a hypervascular cervical mass. The diagnosis of GTN involving the cervix was established based on clinical, radiologic, and biochemical findings. The patient was managed with EMA-CO chemotherapy (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine) as per high-risk GTN protocol. She tolerated the regimen well with only mild adverse effects. Serial β-hCG monitoring demonstrated a consistent decline, and complete remission was achieved after 10 cycles of EMA-CO followed by 2 consolidation cycles. Follow-up imaging confirmed the absence of residual or recurrent disease. This case underscores the effectiveness of EMA-CO chemotherapy in achieving complete remission in high-risk GTN involving the cervix. It highlights the importance of early diagnosis, multidisciplinary coordination, and rigorous post-molar surveillance in improving outcomes for patients with this rare presentation.