Bài báo khoa học Tập 67 Số English Version No 1, 2026 02/06/2026

METASTATIC GESTATIONAL TROPHOBLASTIC NEOPLASIA PRESENTING WITH GASTROINTESTINAL HEMORRHAGE AT THE NATIONAL HOSPITAL OF OBSTETRICS AND GYNECOLOGY – A RARE CASE REPORT

Nguyen Van Thang1, Nguyen Huu Hoang Minh1, Nguyen Duc Ha1, Phan Thu Hang2, Tran Van Nam3
1 National Hospital of Obstetrics and Gynecology
2 Hanoi Medical University
3 Vietnam University of Traditional Medicine and Pharmacy
DOI: 10.52163/yhc.v67iE1.5277
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Từ khóa
Gestational trophoblastic neoplasia, gastrointestinal bleeding, choriocarcinoma, β-hCG.
Tóm tắt

Background: Gastrointestinal metastasis of gestational trophoblastic neoplasia (GTN) is a rare complication and poses a direct threat to life.

Case Presentation: A 53-year-old woman presented with persistent gastrointestinal bleeding due to small bowel intussusception. Serum β-hCG was markedly elevated at 392,406 IU/L. Histopathology and immunohistochemistry confirmed metastatic GTN with multi-organ involvement. The patient was treated initially with low-dose EP chemotherapy followed by EMA-CO chemotherapy, achieving good clinical response and rapid decline of β-hCG levels.

Conclusion: Early β-hCG testing and immunohistochemistry are essential for diagnosis of metastatic lesions of unknown origin in women. Initial low-dose chemotherapy may safely control life-threatening complications in high-risk GTN patients.

Tài liệu tham khảo
[1]
M. J. Seckl, N. J. Sebire, and R. S. Berkowitz, ‘Gestational trophoblastic disease’, Lancet, vol. 376, no. 9742, pp. 717–729, Aug. 2010, doi: 10.1016/S0140-6736(10)60280-2. Google Scholar
[2]
U. P. Khanal, S. Yadav, B. Koirala, A. Khatiwada, and A. K. Yadav, ‘Metastatic choriocarcinoma presenting as upper gastrointestinal bleeding: A case report’, Radiol. Case Rep., vol. 19, no. 12, pp. 5877–5881, Dec. 2024, doi: 10.1016/j.radcr.2024.08.073. Google Scholar
[3]
Y. Wang et al., ‘Intestinal metastasis from choriocarcinoma: a case series and literature review’, World J. Surg. Oncol., vol. 20, p. 173, Jun. 2022, doi: 10.1186/s12957-022-02623-0. Google Scholar
[4]
R. T. West, T. Adams, N. Fakie, and W. C. Mkhombe, ‘Gestational choriocarcinoma in a postmenopausal woman: a case report – lessons for the junior clinician’, South. Afr. J. Gynaecol. Oncol., vol. 15, no. 1, pp. 1–4, Jun. 2023, doi: 10.36303/SAJGO.373. Google Scholar
[5]
I. B. Chang, B. M. Cho, S. H. Park, D. Y. Yoon, and S. M. Oh, ‘Metastatic choriocarcinoma with multiple neoplastic intracranial microaneurysms: case report’, J. Neurosurg., vol. 108, no. 5, pp. 1014–1017, May 2008, doi: 10.3171/JNS/2008/108/5/1014. Google Scholar
[6]
Sayani R., Qamari N. A., Raza R., Haider Z., and Sharif A., ‘Multi-organ Metastatic Choriocarcinoma with Rare Presentation of Small Bowel Intussusception’, J. Perioper. Med., vol. 1, no. 1, pp. 1–3, doi: 10.35248/2684-1290.18.1.105. Google Scholar
[7]
G. Sabetta et al., ‘#380 Ultra high-risk gestational trophoblastic neoplasia: retrospective study of a single cohort at san raffaele scientific institute, milan-italy’, Int. J. Gynecol. Cancer, vol. 33, p. A375, Sep. 2023, doi: 10.1136/ijgc-2023-ESGO.794. Google Scholar