Successful conservative management of primary nonmetastatic cervical choriocarcinoma

Article Abstract:

Choriocarcinoma is a rare cancer that occurs in female reproductive tissue, and localization of this tumor in the cervix is very uncommon. It can be easily confused with other malignant or benign cervical disorders, including cervical pregnancy and threatened miscarriage. The usual treatment of choriocarcinoma involves hysterectomy plus chemotherapy. A case is described of a 33-year-old woman with primary cervical choriocarcinoma who wished to remain fertile. She had three children, with the last born one year before diagnosis of choriocarcinoma. Following the development of irregular bleeding, a cervical lesion was found. Initially the lesion was thought to be the more common squamous cell carcinoma, but reexamination by a second clinic resulted in a diagnosis of choriocarcinoma. The lesion was removed, and tests showed that it had not metastasized, spread to other body areas or the rest of the reproductive tract. Choriocarcinomas typically respond well to methotrexate, and the patient was treated with this plus another drug. The patient remained well one year after treatment. The report indicates that younger patients with non-metastatic choriocarcinoma may be treated appropriately with conservative measures, without hysterectomy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Cervical cancer, Chemotherapy, Choriocarcinoma

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Transvaginal ultrasonography at early pregnancy cannot be used alone for targeted organ ultrasonographic examination in a high-risk population

Article Abstract:

Transvaginal ultrasonography in high-risk women for fetal congenital anomalies in the early second trimester of pregnancy is not sufficient and should be followed by a transabdominal scan at the latest date that abortion is still feasible. A group of 536 women at high risk for congenital anomalies had an ultrasound scan using a vaginal probe between 13 weeks and 16 weeks gestation followed by a transabdominal scan at 18 to 20 weeks gestation. Forty-two anomalies were identified. Twenty-four women chose to have an abortion and one fetus died. At the later scan, eight anomalies (17%) were identified that had not been diagnosed previously and five anomalies diagnosed earlier had disappeared. Many anomalies such as certain heart defects, polycystic kidney disease, or hydrocephalus do not develop or cannot be discerned until later in pregnancy. Other anomalies associated with chromosomal defects such as fluid accumulation in the back of the neck disappear by the late second trimester. Therefore, both scans are recommended for women at high risk for anomalies.

Methods, Usage, Diagnosis, Fetus, Birth defects, Prenatal diagnosis, Prenatal ultrasonography, Ultrasonics in obstetrics

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Expression of gelatinase B by trophoblast cells: down-regulation by progesterone

Article Abstract:

Progesterone appears to regulate the effect of gelatinase B in the trophoblast, which develops into the placenta. Gelatinase B is an enzyme involved in the implantation of the fertilized and growing ovum in the wall of the uterus. Researchers analyzed gelatinase B activity in trophoblast cells. The hormone progesterone decreased the accumulation of the enzyme in the cells, and the progesterone inhibitor onapristone restored enzyme activity. Progesterone may be an important regulator of the processes required for the embryo to establish a connection with the maternal blood supply.

Maternal-fetal exchange, Physiological aspects, Trophoblast, Trophoblasts, Progesterone, Ovum implantation, Collagenases

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