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Recurrent Post-Abortion Gestational Trophoblastic Neoplasia Successfully Treated with TP/TE: A Case Report
Denis Afriansyah1, Adhi Pribadi1, Budi Handono1
1Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital-Padjadjaran University, Bandung, Indonesia.
Introduction:
Gestational trophoblastic neoplasia (GTN) is a highly curable malignancy, but cases arising after abortion are uncommon and often diagnosed late. We report a recurrent high-risk GTN following abortion that relapsed multiple times despite etoposide-methotrexate-actinomycin D/cyclophosphamide-vincristine (EMA/CO).
Case Report:
A 26-year-old woman achieved initial remission with six cycles of EMA/CO but experienced several recurrences from 2021 to 2023. She presented again with rising β-hCG (16,925.8 mIU/mL) and an intrauterine mass. Paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE) was given for six cycles plus two consolidation cycles, resulting in complete remission. β-hCG normalized by January 2024 and remained undetectable for 12 months.
Conclusion:
This case highlights diagnostic challenges of post-abortion GTN and shows that TP/TE is an effective and well-tolerated salvage option for recurrent or EMA/CO-resistant GTN. Long-term β-hCG surveillance is essential to ensure durable remission and assess fertility outcomes.
