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이부순(BS Lee),박영주(YJ Park),주영철(YC Joo),유태숙(TS Yoo) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.10
임신 32주에 병발된 전이성융모암 1예를 경험하였기에 간단한 문헌적 고찰과 아울러 이에 보고하는 바이다. The case to be reported is unusual intersting patient becauses of coexisting metastatic choriocarcinoma and pregnancy. A 32 year old multigravida had genital bleeding from vulvar metastatic lesion of choriocarcinoma at 32 gestational week. During the 1st admission cesarean section and tubal ligation were performed and a living female baby weighing 1,700 gm was delevered. Two courses of methotrexate(12.5mg/day, 72.5mg/course) treatment were cone without notable side effect and patient was discharged with complete remission of trophoblastic tumor. During the 2nd admission total abdominal hysterectomy, left salpingo-oophorectomy and right salpingectomy were performed and possible primary lesion of choriocarcinoma was found at the mid-posterior aspect of uterine cavity. After total 4 courses of methotrexate(72.5mg/day- 100mg/course) treatment without remarkable side effect, patient was discharged with partial remission of trophoblastic tumor. Chest lesions still remained but vulvar metastatic lesion disappeared completely. The patient was readmitted due to severe headache and limitation of extension of the right elbow and knee. Skull x-ray showed several small bean sized metastatic lesions in the skull vault. Left carotid angiography revealed possible brain metastasis from choriocarcinoma, which was disclosed by autopsy later on. In spite of additional 7th & 8th course of methotrexate (37.5mg-75mg/each course) and 6 mercaptopurine (40mg x 3 for 3 days) treatment the patient`s had getting worse and finally, the patient expired on Feb. 19, 1973. Literatures are briefly reviewed.