2022-RA-1234-ESGO Gestational trophoblastic neoplasia: multimodal approach to diagnosis and treatment. (20th October 2022)

• Record Type: Journal Article
• Authors: Rouiss, Hadhami; Bettaieb, Hajer; Bouhmida, Rahma; Souayeh, Nersine; Chermiti, Amal; Ouederni, Meriem; Lamiri, Hadir; Abidi, Idriss; Mbarki, Wael; Oueslati, Hedhili; Mbarki, Chaouki
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A424
• Page End: A424
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.910
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Gestational trophoblastic neoplasia (GTN) is a rare entity. The diagnosis is difficult and based on histological and HCG assays. We report 15 cases of GTN diagnosed at our department. Methodology: We included all patients that fulfill the FIGO criteria of GTN over a period of 18 years. Results: We registered 15 cases of GTN over 18 years. Transvaginal sonography (TVS) revealed an enlarged uterus in 8/15 cases. In one of the 2 cases of Placental site trophoblastic tumor (PSTT), it revealed a well-circumscribed echogenic lesion, the patient was misdiagnosed with uterine fibroma. In the case of invasive mole (IM), the TVS showed intrauterine mass with cystic spaces and signs of myometrial invasion. The invasion has been suspected in the 2 cases of PSTT, the IM and 3 of 9 patients diagnosed of persistent trophoblastic disease (PTD). The biological features were mainly an increased level of HCG. The level exceeded 100000 in 7/9 PTD and in the case of IM. All patients diagnosed of PSTT and choriocarcinoma (CCG) had low values. Lung CT scans showed metastatic nodules in 4 cases but only one patient had visible nodules on the traditional chest X-ray. Five patients received multi-agent chemotherapy, six had single agent chemotherapy, hysterectomy was performed for the patients with PSTT. The overall survival rate was 100%. Conclusion: The improvement of survival for patients with gestational trophoblastic neoplasia is based on early identification. Transvaginal sonography and HCG remains the tools of choice for initial diagnosis.