Lin YY, Sun Y, Jiang Y, Song BZ, Ke LJ. Multidisciplinary treatment of life-threatening hemoptysis and paraplegia of choriocarcinoma with pulmonary, hepatic and spinal metastases: A case report. World J Clin Cases 2020; 8(17): 3867-3874 [PMID: 32953866 DOI: 10.12998/wjcc.v8.i17.3867]
Corresponding Author of This Article
Yang Sun, MD, Dean, Doctor, Surgical Oncologist, Teacher, Department of Gynecology, Fujian Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. fjslyysunyang7@sina.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2020; 8(17): 3867-3874 Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3867
Multidisciplinary treatment of life-threatening hemoptysis and paraplegia of choriocarcinoma with pulmonary, hepatic and spinal metastases: A case report
Yuan-Yuan Lin, Yang Sun, Yu Jiang, Bao-Zhi Song, Li-Juan Ke
Yuan-Yuan Lin, Yang Sun, Department of Gynecology, Fujian Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, Fuzhou 350014, Fujian Province, China
Yuan-Yuan Lin, Yu Jiang, Bao-Zhi Song, Li-Juan Ke, Department of Gynecology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian Province, China
Author contributions: Lin YY reviewed the literature and wrote the manuscript; Sun Y was responsible for revision of the manuscript for important intellectual content; Jiang Y, Song BZ and Ke LJ revised the manuscript; all authors contributed to approval of the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yang Sun, MD, Dean, Doctor, Surgical Oncologist, Teacher, Department of Gynecology, Fujian Cancer Hospital, Affiliated Cancer Hospital of Fujian Medical University, No. 420 Fuma Road, Fuzhou 350014, Fujian Province, China. fjslyysunyang7@sina.com
Received: March 20, 2020 Peer-review started: March 20, 2020 First decision: July 25, 2020 Revised: August 2, 2020 Accepted: August 15, 2020 Article in press: August 15, 2020 Published online: September 6, 2020 Processing time: 168 Days and 4.9 Hours
Abstract
BACKGROUND
Although choriocarcinoma is thought to be a malignancy curable by chemotherapy, there remain difficult and challenging problems in cases with high prognostic scores or extensive metastases, for which the treatment is limited. Particularly, chemotherapy in combination with other treatments offers promising therapeutic potential for these cases.
CASE SUMMARY
We present the case of a 40-year-old female patient who suffered from life-threatening hemoptysis and paraplegia due to choriocarcinoma with pulmonary, hepatic and spinal metastases. The patient successfully recovered after multidisciplinary treatment consisting of 21 cycles of intravenous chemotherapy, radiofrequency ablation of multiple hepatic metastases, intensity-modulated radiation therapy for spinal metastases and routine physiotherapy. To our knowledge, it is the first reported case of recovery from pulmonary, hepatic and spinal metastases of choriocarcinoma with no specific primary site. Moreover, this is the first reported clinical attempt on 5-d actinomycin D as primary chemotherapy in ultrahigh-risk gestational trophoblastic neoplasia.
CONCLUSION
The case supports the opinion that the individualized treatment of choriocarcinoma by a multidisciplinary approach can accomplish optimal therapeutic effects.
Core tip: In this case report, we discuss a case of choriocarcinoma in a patient who presented with life-threatening hemoptysis and paraplegia due to metastases. We review her clinical manifestation and treatment, subsequently discussing the multidisciplinary treatment approach used to successfully treat this patient. Our study provides a new treatment modality for metastatic choriocarcinoma.
