Necrosis of myometrial choriocarcinoma with fulminating sepsis complicating chemotherapy for trophoblastic tumor

K. O. Odunsi, L. L. Peck, E. I. Kohorn, V. Parkash, Bernadette Cracchiolo, J. T. Chambers, K. J. Taylor

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We report a patient who developed metastatic gestational choriocarcinoma following delivery of a normal, healthy child that, however, was anemic and required blood transfusion. The patient developed secondary postpartum hemorrhage over a period of several weeks and required curettage and myometrial contractants to control the bleeding. At the time of diagnosis the patient had extensive pulmonary metastases and ultrasound showed full penetration of the myometrium by tumor. Immediately following the second course of chemotherapy with etoposide, methotrexate, and actinomycin D, alternating with cyclophosphamide and vincristine, the patient developed sepsis associated with a uteroperitoneal fistula and required hysterectomy. The sepsis was associated with disseminated intravascular coagulopathy and adult respiratory distress syndrome. However, the patient's tumor was exquisitely sensitive to chemotherapy and with good intensive care unit support and chemotherapy she survived without residual scar except for the loss of reproductive function. There are two lessons to be learned from these events: (1) The syndrome of secondary post-partum hemorrhage with a fetus that is anemic spells a diagnosis of choriocarcinoma; and (2) color Doppler flow vaginal ultrasound performed at the time of presentation of trophoblastic tumors may be useful to show full penetration of the myometrium by tumor which may be a warning of possible scar rupture in a subsequent pregnancy.

Original languageEnglish (US)
Pages (from-to)100-104
Number of pages5
JournalGynecologic Oncology
Volume70
Issue number1
DOIs
StatePublished - Jan 1 1998

Fingerprint

Trophoblastic Neoplasms
Choriocarcinoma
Sepsis
Necrosis
Drug Therapy
Myometrium
Cicatrix
Hemorrhage
Postpartum Hemorrhage
Neoplasms
Curettage
Adult Respiratory Distress Syndrome
Dactinomycin
Vincristine
Etoposide
Hysterectomy
Methotrexate
Blood Transfusion
Cyclophosphamide
Fistula

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Oncology

Cite this

Odunsi, K. O. ; Peck, L. L. ; Kohorn, E. I. ; Parkash, V. ; Cracchiolo, Bernadette ; Chambers, J. T. ; Taylor, K. J. / Necrosis of myometrial choriocarcinoma with fulminating sepsis complicating chemotherapy for trophoblastic tumor. In: Gynecologic Oncology. 1998 ; Vol. 70, No. 1. pp. 100-104.
@article{ddf8f97f1e4a49b0ba09faa2d879f112,
title = "Necrosis of myometrial choriocarcinoma with fulminating sepsis complicating chemotherapy for trophoblastic tumor",
abstract = "We report a patient who developed metastatic gestational choriocarcinoma following delivery of a normal, healthy child that, however, was anemic and required blood transfusion. The patient developed secondary postpartum hemorrhage over a period of several weeks and required curettage and myometrial contractants to control the bleeding. At the time of diagnosis the patient had extensive pulmonary metastases and ultrasound showed full penetration of the myometrium by tumor. Immediately following the second course of chemotherapy with etoposide, methotrexate, and actinomycin D, alternating with cyclophosphamide and vincristine, the patient developed sepsis associated with a uteroperitoneal fistula and required hysterectomy. The sepsis was associated with disseminated intravascular coagulopathy and adult respiratory distress syndrome. However, the patient's tumor was exquisitely sensitive to chemotherapy and with good intensive care unit support and chemotherapy she survived without residual scar except for the loss of reproductive function. There are two lessons to be learned from these events: (1) The syndrome of secondary post-partum hemorrhage with a fetus that is anemic spells a diagnosis of choriocarcinoma; and (2) color Doppler flow vaginal ultrasound performed at the time of presentation of trophoblastic tumors may be useful to show full penetration of the myometrium by tumor which may be a warning of possible scar rupture in a subsequent pregnancy.",
author = "Odunsi, {K. O.} and Peck, {L. L.} and Kohorn, {E. I.} and V. Parkash and Bernadette Cracchiolo and Chambers, {J. T.} and Taylor, {K. J.}",
year = "1998",
month = "1",
day = "1",
doi = "https://doi.org/10.1006/gyno.1998.5024",
language = "English (US)",
volume = "70",
pages = "100--104",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

Necrosis of myometrial choriocarcinoma with fulminating sepsis complicating chemotherapy for trophoblastic tumor. / Odunsi, K. O.; Peck, L. L.; Kohorn, E. I.; Parkash, V.; Cracchiolo, Bernadette; Chambers, J. T.; Taylor, K. J.

In: Gynecologic Oncology, Vol. 70, No. 1, 01.01.1998, p. 100-104.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Necrosis of myometrial choriocarcinoma with fulminating sepsis complicating chemotherapy for trophoblastic tumor

AU - Odunsi, K. O.

AU - Peck, L. L.

AU - Kohorn, E. I.

AU - Parkash, V.

AU - Cracchiolo, Bernadette

AU - Chambers, J. T.

AU - Taylor, K. J.

PY - 1998/1/1

Y1 - 1998/1/1

N2 - We report a patient who developed metastatic gestational choriocarcinoma following delivery of a normal, healthy child that, however, was anemic and required blood transfusion. The patient developed secondary postpartum hemorrhage over a period of several weeks and required curettage and myometrial contractants to control the bleeding. At the time of diagnosis the patient had extensive pulmonary metastases and ultrasound showed full penetration of the myometrium by tumor. Immediately following the second course of chemotherapy with etoposide, methotrexate, and actinomycin D, alternating with cyclophosphamide and vincristine, the patient developed sepsis associated with a uteroperitoneal fistula and required hysterectomy. The sepsis was associated with disseminated intravascular coagulopathy and adult respiratory distress syndrome. However, the patient's tumor was exquisitely sensitive to chemotherapy and with good intensive care unit support and chemotherapy she survived without residual scar except for the loss of reproductive function. There are two lessons to be learned from these events: (1) The syndrome of secondary post-partum hemorrhage with a fetus that is anemic spells a diagnosis of choriocarcinoma; and (2) color Doppler flow vaginal ultrasound performed at the time of presentation of trophoblastic tumors may be useful to show full penetration of the myometrium by tumor which may be a warning of possible scar rupture in a subsequent pregnancy.

AB - We report a patient who developed metastatic gestational choriocarcinoma following delivery of a normal, healthy child that, however, was anemic and required blood transfusion. The patient developed secondary postpartum hemorrhage over a period of several weeks and required curettage and myometrial contractants to control the bleeding. At the time of diagnosis the patient had extensive pulmonary metastases and ultrasound showed full penetration of the myometrium by tumor. Immediately following the second course of chemotherapy with etoposide, methotrexate, and actinomycin D, alternating with cyclophosphamide and vincristine, the patient developed sepsis associated with a uteroperitoneal fistula and required hysterectomy. The sepsis was associated with disseminated intravascular coagulopathy and adult respiratory distress syndrome. However, the patient's tumor was exquisitely sensitive to chemotherapy and with good intensive care unit support and chemotherapy she survived without residual scar except for the loss of reproductive function. There are two lessons to be learned from these events: (1) The syndrome of secondary post-partum hemorrhage with a fetus that is anemic spells a diagnosis of choriocarcinoma; and (2) color Doppler flow vaginal ultrasound performed at the time of presentation of trophoblastic tumors may be useful to show full penetration of the myometrium by tumor which may be a warning of possible scar rupture in a subsequent pregnancy.

UR - http://www.scopus.com/inward/record.url?scp=0032127637&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032127637&partnerID=8YFLogxK

U2 - https://doi.org/10.1006/gyno.1998.5024

DO - https://doi.org/10.1006/gyno.1998.5024

M3 - Article

VL - 70

SP - 100

EP - 104

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 1

ER -