2013, Cilt 26, Sayı 1, Sayfa(lar) 043-046
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Management of gestational trophoblastic neoplasia with vaginal metastasis
Işın ÜREYEN, Günsu KİMYON, Alper KARALÖK, Ömer Lütfi TAPISIZ, Reyhan ÖCALAN, Taner TURAN, Nurettin BORAN, Gökhan TOLUNAY
Kadın Hastalıkları ve Doğum Kliniği, Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Türkiye
Anahtar Kelimeler: Gestational trophoblastic neoplasia, Vaginal metastasis, Methotrexate, Actinoycin-D

A patient who had gestational trophoblastic neoplasia (GTN) with vaginal metastasis resistant to sequential methotrexatefolinic acid (MTX-FA) treatment is presented. She was 25 years old and presented with vaginal bleeding. A curettage was performed and the pathology revealed a partial hydatidiform mole. There was a rise in β-hCG, a 2 cm metastatic lesion on the middle third of the right wall of the vagina, and there were nodular implants up to a size of 12 mm in both lungs. Therefore, she was diagnosed as having a GTN. She was considered as having low risk metastatic GTN, as her modified WHO score was 3. She took seven cycles of sequential MTX-FA theraphy. She was accepted as resistant to MTX-FA and her treatment was changed to actinoycin-D, because her β-hCG values plateaued. Her β-hCG was normalized after the second cycle of actinoycin-D. She took 2 additional cycles of actinoycin-D. Resistance to MTXFA may develop in patients who had a GTN with vaginal metastasis, even though they have low risk scores. These patients may respond to actinoycin-D.

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