Long-term outcome of ultrasound-guided focused ultrasound ablation for gestational trophoblastic neoplasia in the cesarean scar: a case report

作者全名："Qu, Dacheng; Chen, Yan; Jiang, Jing; Shi, Qiuling; Zhou, Honggui; Wang, Zhibiao"

作者地址："[Qu, Dacheng; Shi, Qiuling; Wang, Zhibiao] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing 400016, Peoples R China; [Qu, Dacheng; Wang, Zhibiao] Chongqing Med Univ, Chongqing Key Lab Biomed Engn, Chongqing 400016, Peoples R China; [Qu, Dacheng; Chen, Yan; Jiang, Jing; Zhou, Honggui] North Sichuan Med Coll, Dept Obstet & Gynecol, Affiliated Hosp, Nanchong 637000, Peoples R China; [Qu, Dacheng; Zhou, Honggui] North Sichuan Med Coll, Noninvas & Microinvas Lab Gynecol, Affiliated Hosp, Nanchong 637000, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing, Peoples R China"

通信作者："Wang, ZB (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing 400016, Peoples R China.; Wang, ZB (通讯作者)，Chongqing Med Univ, Chongqing Key Lab Biomed Engn, Chongqing 400016, Peoples R China.; Zhou, HG (通讯作者)，North Sichuan Med Coll, Dept Obstet & Gynecol, Affiliated Hosp, Nanchong 637000, Peoples R China.; Zhou, HG (通讯作者)，North Sichuan Med Coll, Noninvas & Microinvas Lab Gynecol, Affiliated Hosp, Nanchong 637000, Peoples R China."

来源：BMC WOMENS HEALTH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000899536700001

JCR分区：Q2

影响因子：2.5

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Gestational trophoblastic neoplasia; Cesarean scar; High intensity focused ultrasound; Noninvasively; Uterus preservation

摘要："Background: The treatment of gestational trophoblastic neoplasia (GTN) is one of the success stories in medical oncology. GTN in the cesarean scar is a rare entity, but most cases need to be treated with hysterectomy or localized uterine lesion resection because of chemoresistant lesions and/or massive bleeding. We present a patient with post-molar GTN in the cesarean scar who was non-invasively treated with ultrasound-guided high intensity focused ultrasound (HIFU) to preserve the uterus and fertility. Case presentation: A 32-year-old woman was diagnosed with low-risk GTN (FIGO Stage I: 2 prognostic score) after partial hydatidiform mole. The 5th cycle of chemotherapy was interrupted because of persistent hepatic toxicity and impaired ovarian reserve function. However, the uterine lesion persisted (diameter of residual uterine lesion in the cesarean scar: 2.0 cm). Therefore, ultrasound-guided HIFU treatment was performed. A significant gray-scale change was observed during the HIFU treatment. Color Doppler ultrasonography and contrast-enhanced ultrasound (CEUS) was performed to evaluate the ablation effectiveness. Color Doppler ultrasonography showed disappearance of the signal of vascularity and CEUS showed no perfusion in the lesion located in the cesarean scar. The uterine lesion was obviously shrunken one month after HIFU treatment. Menstrual cycle resumed 48 days after HIFU. HIFU treatment decreased the number of chemotherapy cycles and there was complete disappearance of the GTN lesion at 4-month follow-up. The patient has shown no signs of recurrence as of 58-month follow-up. Conclusion: Ultrasound-guided HIFU may be a useful alternative to lesion resection for GTN in the cesarean scar in patients who show chemoresistance or are not suitable for chemotherapy. It has the potential to ablate the residual uterine lesion noninvasively to preserve the uterus and fertility, avoiding perioperative risks of lesion resection, especially acute bleeding."

基金机构：　

基金资助正文：