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

Yıl 2026, Cilt: 26 Sayı: 1 , 31 - 37 , 22.04.2026

Tuba Düzcan , Görker Sel , Serap Topkara Sucu , Ülkü Özmen , Anıl Turhan Çakır , İnan İlker Arıkan , Müge Harma , Mehmet Harma , Aykut Barut

https://izlik.org/JA83YB64HM

Öz

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.

Anahtar Kelimeler

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

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

https://izlik.org/JA83YB64HM

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• Sel G, Çakır T A, Harma M. “Yüksek ve Ultra Yüksek Riskli Gestasyonel Trofoblastik Neoplazilerin Klinik Yönetimi”, Gestasyonel Trofoblastik Hastalıklara Genel Bakış, p 95-107, Güneş Tıp Kitapevi, 2020, Ankara, ISBN:978-975-277-799-6.
• A Ayhan, N Reed, M Gultekin, P Dursun. Gestational Trophoblastic Diseases in: Textbook of Gynaecological Oncology. Gunes Publishing. 2012; 468-474.
• Cortes-Charry R, Figueira LM, Garcia-Barriola V, Gomez C, Garcia I, Santiago C. Gestational trophoblastic disease in ectopic pregnancy: A case series. The Journal of reproductive medicine. 2006 Oct 1;51(10):760-3.
• Altieri A, Franceschi S, Ferlay J, Smith J, La Vecchia C. Epidemiology and aetiology of gestational trophoblastic diseases. The lancet oncology. 2003 Nov 1;4(11):670-8.
• Kendall A, Gillmore R, Newlands E. Chemotherapy for trophoblastic disease: current standards. Current Opinion in Obstetrics and Gynecology. 2002 Feb 1;14(1):33-8.
• Nugent D, Hassadia A, Everard J, Hancock BW, Tidy JA. Postpartum choriocarcinoma presentation, management and survival. The Journal of Reproductive Medicine. 2006 Oct 1;51(10):819-24.
• Ngan HYS, Bender H, Benedet JL, et al. Gestational trophoblastic neoplasia, FIGO staging and classification. Int J Gynecol Obstet 2003;83:175–7.
• FIGO Committee on Gynecologic Oncology. Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet. 2009 Apr. 105(1):3-4.
• Ozalp SS, Yalcin OT, Tanir HM. A hospital-based multicentric study results on gestational trophoblastic disease management status in a developing country. European Journal of Gynaecological Oncology. 2001 Jan 1;22(3):221-2.
• Lan Z, Hongzhao S, Xiuyu Y, Yang X. Pregnancy outcomes of patients who conceived within 1 year after chemotherapy for gestational trophoblastic tumor: a clinical report of 22 patients. Gynecologic oncology. 2001 Oct 1;83(1):146-8.