The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

A case report of successful treatment of gestational trophoblastic neoplasia with uterine artery embolization and chemotherapy

Document Type : Case report

Authors
Sati Nik Darzi 1
Elham Saffarieh 2
1 Assistant Professor, Department of Obstetrics and Gynecology, Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
2 Associate Professor, Department of Obstetrics and Gynecology, Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.
10.22038/ijogi.2023.21799
Abstract
Introduction: Gestational trophoblastic neoplasia (GTN) is a rare disorder, especially in nulliparous women. This study introduced a patient with GTN who underwent successful and uncomplicated treatment of uterine artery embolization and chemotherapy.
Case presentation: The patient was a 29-year-old woman with a history of two pregnancies who referred to Amiralmomeni hospital of Semnan with complaint of severe vaginal bleeding. On ultrasonography, the hypo-echo mass with cystic changes was seen in favor of GTN. Due to the young age of the patient and to preserve the uterus and re-pregnancy, treatment was performed with uterine artery embolization and then chemotherapy, and treatment was successful.
Conclusion: In patients with GTN, uterine artery embolization along with chemotherapy can be considered an effective treatment with minimal complications, especially in young nulliparous women who are interested in preserving the uterus.
Keywords
Chemotherapy
Gestational trophoblastic neoplasia
Molar pregnancy
Uterine artery embolization
  1. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dash JS, Hoffman BL, et al. Williams Obstetrics. 24nd New York: McGraw-Hill; 2014.
  2. Muminhodžić L, Bogdanović G, Ljuca D, Babović A. Epidemiological factors and pathomorphologic characteristics of hydatidiform mole. Journal of Health Sciences 2013; 3(2):129-37.
  3. Hancock BW, Nazir K, Everard JE. Persistent gestational trophoblastic neoplasia after partial hydatidiform mole incidence and outcome. The Journal of reproductive medicine 2006; 51(10):764-6.
  4. Rahmani M, Foroozi S, Akhavan S, Yarandi F, Aminimoghaddam S. OC27. 01: Role of imaging in assessment of gestational trophoblastic neoplasia and transvaginal Doppler ultrasound versus pelvic dynamic contrast enhanced MRI. Ultrasound in Obstetrics & Gynecology 2016; 48:49-50.
  5. Joneborg U, Eloranta S, Johansson AL, Marions L, Weibull CE, Lambe M. Hydatidiform mole and subsequent pregnancy outcome: a population-based cohort study. American Journal of Obstetrics and Gynecology 2014; 211(6):681-e1.
  6. Steigrad SJ. Epidemiology of gestational trophoblastic diseases. Best practice & research Clinical obstetrics & gynaecology 2003; 17(6):837-47.
  7. Drake RD, Rao GG, McIntire DD, Miller DS, Schorge JO. Gestational trophoblastic disease among Hispanic women: a 21-year hospital-based study. Gynecologic oncology 2006; 103(1):81-6.
  8. Ziaie T, Khanjani H, Yazdani MA. Survey risk factors in pregnant women who suffer from hydatidiform mole and its clinical course in Alzahra hospital in Rasht from 2003-2007. Journal of Holistic Nursing and Midwifery 2010; 20(1):27-32.
  9. Goldstein DP, Berkowitz RS. Current management of gestational trophoblastic neoplasia. Hematology/Oncology Clinics 2012; 26(1):111-31.
  10. Lobo RM, Taha M, Herod JJ, Al Ansari A, Syed S, Al Malik H, et al. Management of acute haemorrhage following chemotherapy for invasive molar pregnancy by embolization and conservative fertility-sparing surgery. Gynecologic Oncology Reports 2020; 32:100556.
  11. Liu Z, Wang Y, Yan J, Li J, Liu X, Zhang L, et al. Uterine artery embolization versus hysterectomy in the treatment of refractory postpartum hemorrhage: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2020; 33(4):693-705.
  12. Imafuku H, Yamada H, Morizane M, Tanimura K. Recurrence of post‐partum hemorrhage in women with a history of uterine artery embolization. Journal of Obstetrics and Gynaecology Research 2020; 46(1):119-23.
  13. Mohan PP, Hamblin MH, Vogelzang RL. Uterine artery embolization and its effect on fertility. Journal of Vascular and Interventional Radiology 2013; 24(7):925-30.
  14. Bonduki CE, Feldner Jr PC, da Silva J, Castro RA, Sartori MG, Girão MJ. Pregnancy after uterine arterial embolization. Clinics 2011; 66(5):807-10.
  15. Delplanque S, Le Lous M, Proisy M, Joueidi Y, Bauville E, Rozel C, et al. Fertility, pregnancy, and clinical outcomes after uterine arteriovenous malformation management. Journal of Minimally Invasive Gynecology 2019; 26(1):153-61.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 12
February 2023
Pages 124-127