Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum human chorionic gonadotropin (hCG) was measured by a radioreceptorassay (RRA) and radioimmunoassay (RIA) and serum hCG-beta and hCG-alpha by RIA in 10 patients with intact mole, 3 patients with choriocarcinoma, and 4 patients with hydatidiform mole during treatment. hCG levels by RRA were higher in 5 of 10 molar pregnancies and ranged from 20,900 to 100,000 ng/ml and from 30,000 to 100,000 ng/ml by RIA. hCG levels by RRA and RIA paralleled one another closely during treatment of hydatidiform mole. hCG-alpha was higher than hCG by RRA and RIA and hCG-beta in molar pregnancies, in the uterine venous blood draining a uterine choriocarcinoma, and during chemotherapy of choriocarcinoma. In 2 of 3 choriocarcinoma patients who eventually developed cerebral metastases, hCG-alpha increased while hCG and hCG-beta were declining or negative. hCG-beta was usually lower than hCG or hCG-alpha in all the cases studied. These results demonstrate the production of free alpha and beta subunits in trophoblastic disease. Further, due to the biospecificity, simplicity, and rapidity, the RRA of hCG is a sueful diagnostic aid during treatment of trophoblastic neoplasia until the levels fall to within the sensitivity range of the assay. Finally, the RIA of hCG, hCG-beta, and hCG-alpha, which requires several days, should be performed until they become negative or fall within normal range.
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PMID:Human chorionic gonadotropin and its subunits in hydatidiform mole and choriocarcinoma. 19 42

Review of a world literature of 93 reported cases of choriocarcinoma primary in the fallopian tube yields 58 acceptable cases, to which 18 are added from the files of the Armed Forces Institute of Pathology. Patients ranged from 16 to 56 years old, with a mean age of 33. About 66% presented with acute symptoms consistent with banal ectopic pregnancy. The remainder usually presented with a gradually expanding adnexal mass clinically indistinguishable from an ovarian tumor. Grossly, the tumor is usually a hemorrhagic friable mass, occasionally containing spongy tissue resembling placenta. Smaller tubal choriocarcinomas are difficult to distinguish on gross inspection from common ectopic pregnancy, ruptured or not. Histopathological features and distribution of metastases are similar to gestational choriocarcinoma arising in the uterus. Chorionic villi were found in two cases, an uncommon observation in primary uterine choriocarcinoma. Of 47 acceptable cases treated prior to modern chemotherapy, 41 died, a mortality of 87%. Of 16 cases treated with modern chemotherapy, 15 survive, a salvage of 94%. Five cases in the world literature, plus three in the present series, were cured by unilateral salpingectomy or salpingo-oophorectomy alone.
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PMID:Gestational choriocarcinoma of the fallopian tube. 703 13

Trophoblastic disease is usually related to pregnancy and occurs in about 1 in 1300 pregnancies in Western countries. Since the advent of methotrexate therapy, trophoblastic tumors have become one of the most curable malignancies. Trophoblastic disease can develop independently of gestation, but this is very rare. We report the unusual case of a 58-year-old woman who had a metastatic choriocarcinoma 6 years after menopause and 29 years after her last pregnancy. The tumor proved to be primarily resistant to monochemotherapy and developed chemoresistance to three different polychemotherapeutic regimens. Eleven months after the diagnosis of uterine choriocarcinoma the patient died from advanced metastatic disease.
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PMID:Metastatic choriocarcinoma in a postmenopausal woman. 864 28

Pulmonary metastases from choriocarcinoma can very rarely give rise to a 'miliary' pattern on the chest X-ray. A 23-year-old woman with a diffuse nodular pattern on chest X-ray died due to acute respiratory failure and cor pulmonale. At autopsy, choriocarcinoma of the uterus was found. In the lungs, multiple macrovascular tumour emboli within branches of pulmonary muscular arteries in the region of segmental/subsegmental bronchi were detected. There was no evidence of pulmonary parenchymal metastases, pneumonia or tuberculosis. The 'miliary' pattern of pulmonary metastases described in cases of choriocarcinoma may be due to large vessel intra-arterial tumour emboli rather than disseminated parenchymal metastases.
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PMID:A case of pulmonary tumour embolism mimicking miliary tuberculosis. 1102 95

We report a case of uterine choriocarcinoma in a 42-year-old female presenting with abdominal pain, uterus enlargement, high serum levels of beta human chorionic gonadotropin (b-hCG) and a positive pregnancy test on two separate occasions. At laparatomy, blood and clots were observed in the abdomen, an enlarged uterus with tumor infiltrates in the uterus, appendix, bladder and plica vesico-uterina. Follwing hysterectomy and bilateral oophoorectomy, the patient received chemotherapy and was followed for two years. No tumor recurrences were observed and the b-hCG levels returned to normal. In conclusion, the condition responds favorably the chemotherapy and recurrences are rate when there are no metastases to the liver or the brain.
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PMID:[Chemotherapy-sensitive uterine choriocarcinoma: a case report]. 2019 88

Complete hydatidiform (also referred to as hydatiform) mole with coexisting live fetus is an exceedingly rare event. The fetus usually has a normal karyotype, and approximately 25-40% chance of survival, if pregnancy is allowed to continue until reasonable fetal lung maturity is achieved. However, risk of maternal complications including preeclampsia and subsequent trophoblastic disease are significant. We report a case of a 19-year-old primigravida, at 25 weeks gestation with a complete hydatidiform mole and a coexisting live fetus. She developed severe preeclampsia with uncontrolled hypertension, and pregnancy was terminated by caesarean section, after a short course of dexamethasone to accelerate fetal lung maturity. A morphologically normal live female fetus and placenta were delivered without complications, along with a separate mass of complete mole. The postpartum course was complicated by uterine choriocarcinoma with metastases to lung and left kidney, which responded to chemotherapy. Our case is a rare example of a twin gestation composed of a complete hydatidiform mole with a coexisting live fetus, and illustrates the associated spectrum of maternal complications that mandate close pre- and post-natal surveillance.
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PMID:Twin gestation with complete hydatidiform mole and a coexisting live fetus: case report and brief review of literature. 2758 37

Choriocarcinoma is a highly malignant neoplasm arising from the trophoblast of a human pregnancy, which may have distant spread to multiple organs, particularly to the lung. We report a case of a pulmonary arteriovenous fistula that developed after chemotherapy within a choriocarcinoma metastasis. A 24-year-old female with a history of uterine choriocarcinoma presented with multiple hypervascular pulmonary nodules on the initial chest computed tomography (CT) scan, consistent with lung metastases. Four months after chemotherapy, follow-up chest CT revealed a decrease in the size and vascularity of the lung metastases, except for 1 nodule that persisted with marked contrast enhancement and developed a communication with a pulmonary artery and vein. These findings were consistent with an acquired arteriovenous fistula. Physicians should be aware of the risk of acquired arteriovenous fistula in pulmonary metastases after chemotherapy because it can lead to a right-to-left shunt, pulmonary hemorrhage, and paradoxical emboli. It is also important for the definition of therapeutic planning, in order to avoid it being misdiagnosed as a site of disease progression.
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PMID:Acquired Pulmonary Arteriovenous Fistula within Metastasis from Choriocarcinoma: A Case Report. 2887 48