Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0268596 (EMA)
 2,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The management of late gestational trophoblastic disease recurrence is challenging. We present a case of a 16-year-old woman who was diagnosed with a gestational trophoblastic neoplasia 14 months after her hydatidiform mole pregnancy. A staging was performed revealing only an intramural lesion, which resembled a myoma, in the fundus of the uterus. Despite two course of methotrexate, the human chorionic gonadotropin (hCG) level increased slowly. The presentation was highly suggestive for a placental site trophoblastic tumor. A local resection of the tumor by hysterotomy was performed. Pathologic examination revealed a choriocarcinoma with tumor-free surgical margins. Subsequently, the patient received three cycles of EMA-CO (etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristine). At present, 89 months after the hysterotomy, the patient is well, with no sings of recurrence. This report illustrates that it is mandatory to have a histologic diagnosis of chemoresistant gestational trophoblastic neoplasia before performing definitive surgery.
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PMID:The role of hysterotomy in the management of gestational trophoblastic neoplasia. 1668 77

Ulipristal Acetate (UPA) is the only selective progesterone receptor modulator currently approved for medical management of myomas. Following several cases of liver toxicity during UPA treatment, new recommendations of PRAC (Pharmacovigilance Risk Assessment Committee) and EMA (European Medicines Agency) have been proposed, including a pre-therapeutic assessment of liver function and a close monitoring during treatment. Repeated courses of UPA have also been restricted to women who are defined as "non-eligible" for surgery. This article raises important questions and tries to provide clarification about the concept of 'non-eligibility' for myoma surgery.
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PMID:What does non-eligibility for myoma surgery mean in the context of sequential prescription of ulipristal acetate? 3197 53