Beyin, dalak ve akciğer metastazları olan ve kemoterapi ile başarıyla tedavi edilen koryokarsinom olgu sunumu

Abstract

Koryokarsinom, gestasyonel trofoblastik neoplazilerin en agresif formu olup erken vasküler invazyon ve yaygın metastaz eğilimi ile karakterizedir. En sık akciğer, beyin ve karaciğer metastazları görülür. Bu olgu sunumunda, beyin, dalak ve akciğer metastazları gelişen ve kemoterapi ile başarıyla tedavi edilen bir koryokarsinom olgusu sunulmuştur. Otuz yaşındaki hasta, doğumdan 18 ay sonra sağ hemipleji ve konuşma bozukluğu ile başvurmuştur. Beyin BT’sinde frontoparietal metastaz saptanmış, beta-hCG değeri 5753 mIU/ml bulunmuştur. Hasta yüksek riskli olarak değerlendirilmiş, EMA-CO kemoterapisi ve kranial radyoterapi uygulanmıştır. Relaps sonrası EMA-EP protokolü başlanmış ve tam yanıt elde edilmiştir. Hastanın 5 yıllık izleminde nüks saptanmamıştır. Koryokarsinom, agresif seyirli olmasına karşın kombine kemoterapiye oldukça duyarlı olup, beta-hCG takibi tanı ve izlemde kritik öneme sahiptir.

Keywords

• koryokarsinom
• metastaz
• Gestasyonel trofoblastik neoplazi
• EMA-CO
• EMA-EP

A case report of choriocarcinoma with brain, spleen and lung metastases successfully treated with chemotherapy.

Abstract

Choriocarcinoma is the most aggressive form of gestational trophoblastic neoplasia, characterized by early vascular invasion and widespread metastases, most commonly to the lungs, brain, and liver. We present a case of choriocarcinoma with brain, spleen, and lung metastases successfully treated with chemotherapy. A 30-year-old woman presented 18 months after term delivery with right hemiplegia and speech disturbance. Brain CT revealed a frontoparietal metastasis, and the serum beta-hCG was 5753 mIU/ml. She was diagnosed as high-risk choriocarcinoma and treated with EMA-CO chemotherapy and cranial radiotherapy. After relapse, the EMA-EP regimen was initiated, resulting in complete remission. No recurrence was detected during the 5-year follow-up. Despite its aggressive nature, choriocarcinoma is highly sensitive to combination chemotherapy, and serial beta-hCG measurement remains essential for diagnosis and monitoring.

Keywords

• Choriocarcinoma
• Gestational trophoblastic neoplasia
• EMA-CO
• EMA-EP
• Metastasis

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