Speaker
Description
Introduction- Gestational tropholastic neoplasia is of uncommon occurrence in the post-menopausal women, unlike in the reproductive age group. The diagnosis is based on levels of beta-hCG in serum. The management is similar to that in the pre-menopausal women.
Case reports- Case 1- 52 years old, P8L4A3 post-menopausal lady, presented with post-menopausal bleeding. Diagnosis of choriocarcinoma was made in view of raised serum beta-hCG levels with uterine lesion with lung metastasis. Patient started on Multi-agent chemotherapy. Patient succumbed to death due to Grade III hematological toxicity while on first cycle of EMA/CO regimen.
Case 2- 42 years old, P2L2, post-menopausal, with history of Choriocarcinoma 20years back presented with post-menopausal bleeding. After metastatic work-up, patient started on EMACO regimen. She is asymptomatic and on regular follow-up after 8cycles of chemotherapy.
Case 3- 47years old P4L4, post-menopausal, presented with histopathology report suggestive of choriocarcinoma after hysterectomy. After evaluation, lung metastasis were detected. Patient responded to 8cycles to Multi-agent chemotherapy and is on regular follow-up.
Conclusion- Choriocarcinoma is rare gynecological malignancy in the post-menopausal women. High index of suspicion is required for its diagnosis. Prognosis of the disease is not encouraging as compared to pre-menopausal woman.
