%0 Journal Article
%T Management of gestational trophoblastic neoplasia with vaginal metastasis
%A I£¿£¿n ¨¹REYEN
%A G¨¹nsu K£¿MYON
%A Alper KARAL£¿K
%A £¿mer L¨¹tfi TAPISIZ
%J Marmara Medical Journal
%D 2013
%I Marmara University
%X A patient who had gestational trophoblastic neoplasia (GTN) with vaginal metastasis resistant to sequential methotrexatefolinic acid (MTX-FA) treatment is presented. She was 25 years old and presented with vaginal bleeding. A curettage was performed and the pathology revealed a partial hydatidiform mole. There was a rise in ¦Â-hCG, a 2 cm metastatic lesion on the middle third of the right wall of the vagina, and there were nodular implants up to a size of 12 mm in both lungs. Therefore, she was diagnosed as having a GTN. She was considered as having low risk metastatic GTN, as her modified WHO score was 3. She took seven cycles of sequential MTX-FA theraphy. She was accepted as resistant to MTX-FA and her treatment was changed to actinoycin-D, because her ¦Â-hCG values plateaued. Her ¦Â-hCG was normalized after the second cycle of actinoycin-D. She took 2 additional cycles of actinoycin-D. Resistance to MTXFA may develop in patients who had a GTN with vaginal metastasis, even though they have low risk scores. These patients may respond to actinoycin-D.
%K Gestational trophoblastic neoplasia
%K Vaginal metastasis
%K Methotrexate
%K Actinoycin-D
%U http://mmj.dergisi.org/pdf.php3?id=659