Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman

Gestational trophoblastic neoplasia (GTN) with brain metastasis is usually seen in patients with advanced disease. Ten percent of metastatic gestational trophoblastic disease involves the brain and spinal cord, most often manifesting as an intracerebral mass or subdural hematoma, and are generally k...

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Main Authors: Nnamdi I. Gwacham, Lindsey Van Brunt, Yizhou Ernst, Darlene Gibbon
Format: Article
Language:English
Published: Elsevier 2019-08-01
Series:Gynecologic Oncology Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2352578919300578
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spelling doaj-60040dabc66a4f3e82af2cfd5eac00012020-11-25T00:19:15ZengElsevierGynecologic Oncology Reports2352-57892019-08-01292933Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old womanNnamdi I. Gwacham0Lindsey Van Brunt1Yizhou Ernst2Darlene Gibbon3Corresponding author at: Department of Obstetrics & Gynecology, Saint Barnabas Medical Center, 94 Old Short Hills Rd., Livingston, NJ 07039, USA.; Department of Obstetrics & Gynecology, Saint Barnabas Medical Center, Livingston, NJ, USADepartment of Obstetrics & Gynecology, Saint Barnabas Medical Center, Livingston, NJ, USADepartment of Obstetrics & Gynecology, Saint Barnabas Medical Center, Livingston, NJ, USADepartment of Obstetrics & Gynecology, Saint Barnabas Medical Center, Livingston, NJ, USAGestational trophoblastic neoplasia (GTN) with brain metastasis is usually seen in patients with advanced disease. Ten percent of metastatic gestational trophoblastic disease involves the brain and spinal cord, most often manifesting as an intracerebral mass or subdural hematoma, and are generally known to be a poor prognostic factor (Dadlani et al., 2010). Leptomeningeal metastases are tremendously rare and not well documented in the literature. A standardized treatment regimen for patients with brain metastases has not been established and is controversial due to a number of multimodal treatments that have been published in the literature without a prospective trial having been completed. We report a case of a patient with gestational trophoblastic disease that metastasized to the lung and leptomeninges, who after treatment with induction chemotherapy using etoposide (E) and cisplatin (P) followed by etoposide, methotrexate and dactinomycin (EMA) chemotherapy achieved a complete response without brain radiation (Han et al., 2012). Keywords: Leptomeningeal spread, GTN, Cerebral metastasis, Lung involvement, High riskhttp://www.sciencedirect.com/science/article/pii/S2352578919300578
collection DOAJ
language English
format Article
sources DOAJ
author Nnamdi I. Gwacham
Lindsey Van Brunt
Yizhou Ernst
Darlene Gibbon
spellingShingle Nnamdi I. Gwacham
Lindsey Van Brunt
Yizhou Ernst
Darlene Gibbon
Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
Gynecologic Oncology Reports
author_facet Nnamdi I. Gwacham
Lindsey Van Brunt
Yizhou Ernst
Darlene Gibbon
author_sort Nnamdi I. Gwacham
title Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
title_short Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
title_full Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
title_fullStr Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
title_full_unstemmed Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
title_sort leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman
publisher Elsevier
series Gynecologic Oncology Reports
issn 2352-5789
publishDate 2019-08-01
description Gestational trophoblastic neoplasia (GTN) with brain metastasis is usually seen in patients with advanced disease. Ten percent of metastatic gestational trophoblastic disease involves the brain and spinal cord, most often manifesting as an intracerebral mass or subdural hematoma, and are generally known to be a poor prognostic factor (Dadlani et al., 2010). Leptomeningeal metastases are tremendously rare and not well documented in the literature. A standardized treatment regimen for patients with brain metastases has not been established and is controversial due to a number of multimodal treatments that have been published in the literature without a prospective trial having been completed. We report a case of a patient with gestational trophoblastic disease that metastasized to the lung and leptomeninges, who after treatment with induction chemotherapy using etoposide (E) and cisplatin (P) followed by etoposide, methotrexate and dactinomycin (EMA) chemotherapy achieved a complete response without brain radiation (Han et al., 2012). Keywords: Leptomeningeal spread, GTN, Cerebral metastasis, Lung involvement, High risk
url http://www.sciencedirect.com/science/article/pii/S2352578919300578
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