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Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review

BACKGROUND: Primary cervical gestational trophoblastic neoplasias (GTNs) are extremely rare ectopic GTNs. Such lesions are difficult to diagnose clinically because of their rarity, with abnormal vaginal bleeding of a non-specific cause being the most common symptom. To that end, this retrospective s...

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Autores principales: Wang, Xiaoyu, Yang, Junjun, Wan, Xirun, Feng, Fengzhi, Zhao, Jun, Ren, Tong, Xiang, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600730/
https://www.ncbi.nlm.nih.gov/pubmed/34794477
http://dx.doi.org/10.1186/s13023-021-02111-w
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author Wang, Xiaoyu
Yang, Junjun
Wan, Xirun
Feng, Fengzhi
Zhao, Jun
Ren, Tong
Xiang, Yang
author_facet Wang, Xiaoyu
Yang, Junjun
Wan, Xirun
Feng, Fengzhi
Zhao, Jun
Ren, Tong
Xiang, Yang
author_sort Wang, Xiaoyu
collection PubMed
description BACKGROUND: Primary cervical gestational trophoblastic neoplasias (GTNs) are extremely rare ectopic GTNs. Such lesions are difficult to diagnose clinically because of their rarity, with abnormal vaginal bleeding of a non-specific cause being the most common symptom. To that end, this retrospective study aimed to identify the clinical characteristics of cervical GTN and to explore diagnostic and therapeutic strategies. RESULTS: Thirteen patients diagnosed with primary cervical GTN at the Department of Gynecology, Peking Union Medical College Hospital, Beijing, China, between June 1, 1988 and May 31, 2020 were included in the study. All patients had irregular vaginal bleeding, including six who presented with massive bleeding. Seven patients (53.8%) were initially misdiagnosed with a cervical pregnancy. All patients received chemotherapy; 11 (84.6%) also underwent hysterectomy because of chemoresistant lesions or uncontrolled bleeding. All patients achieved complete remission; however, two women (15.4%) experienced a relapse during the median follow-up period of 35 months. A comprehensive review of English-language literature published between 1980 and 2020 identified 22 case reports encompassing 27 patients. The definitive diagnosis was achieved via pathology in 26 of them (96.3%), and hysterectomy was performed in 21 (77.8%). CONCLUSIONS: Owing to its rarity and nonspecific symptoms, the diagnosis of primary cervical GTN is challenging and often relies on pathology. The combination of chemotherapy and hysterectomy is the main therapeutic strategy for this disease.
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spelling pubmed-86007302021-11-19 Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review Wang, Xiaoyu Yang, Junjun Wan, Xirun Feng, Fengzhi Zhao, Jun Ren, Tong Xiang, Yang Orphanet J Rare Dis Research BACKGROUND: Primary cervical gestational trophoblastic neoplasias (GTNs) are extremely rare ectopic GTNs. Such lesions are difficult to diagnose clinically because of their rarity, with abnormal vaginal bleeding of a non-specific cause being the most common symptom. To that end, this retrospective study aimed to identify the clinical characteristics of cervical GTN and to explore diagnostic and therapeutic strategies. RESULTS: Thirteen patients diagnosed with primary cervical GTN at the Department of Gynecology, Peking Union Medical College Hospital, Beijing, China, between June 1, 1988 and May 31, 2020 were included in the study. All patients had irregular vaginal bleeding, including six who presented with massive bleeding. Seven patients (53.8%) were initially misdiagnosed with a cervical pregnancy. All patients received chemotherapy; 11 (84.6%) also underwent hysterectomy because of chemoresistant lesions or uncontrolled bleeding. All patients achieved complete remission; however, two women (15.4%) experienced a relapse during the median follow-up period of 35 months. A comprehensive review of English-language literature published between 1980 and 2020 identified 22 case reports encompassing 27 patients. The definitive diagnosis was achieved via pathology in 26 of them (96.3%), and hysterectomy was performed in 21 (77.8%). CONCLUSIONS: Owing to its rarity and nonspecific symptoms, the diagnosis of primary cervical GTN is challenging and often relies on pathology. The combination of chemotherapy and hysterectomy is the main therapeutic strategy for this disease. BioMed Central 2021-11-18 /pmc/articles/PMC8600730/ /pubmed/34794477 http://dx.doi.org/10.1186/s13023-021-02111-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wang, Xiaoyu
Yang, Junjun
Wan, Xirun
Feng, Fengzhi
Zhao, Jun
Ren, Tong
Xiang, Yang
Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title_full Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title_fullStr Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title_full_unstemmed Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title_short Identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
title_sort identification and treatment of primary cervical gestational trophoblastic neoplasia: a retrospective study of 13 patients and literature review
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600730/
https://www.ncbi.nlm.nih.gov/pubmed/34794477
http://dx.doi.org/10.1186/s13023-021-02111-w
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