[Clinical analysis of 13 cases of gestational trophoblastic tumor misdiagnosed as ectopic pregnancy]

Abstract

Objective: To evaluate clinical-pathological features, diagnosis and therapy of gestational trophoblastic tumor (GTT) misdiagnosed as ectopic pregnancy.

Methods: From 1999 to 2003, a total of 13 patients with GTT misdiagnosed as ectopic pregnancy were retrospectively analyzed.

Results: The main symptoms were amenorrhea, abdominal pain, irregular vaginal bleeding. Serum beta-human chorionic gonadotrop in (hCG) was measured in 10 patients. Eight had hCG values above 10,000 IU/L; 3 had hCG values above 50,000 IU/L. The lesions of GTT misdiagnosed as ectopic pregnancy were fallopian tube, horn of uterus, peritoneal cavity, greater omentum, recto-uterine pouch. According to standards of the International Federation of Gynecology and Obstetrics (FIGO) the 13 patients were categorized as 6 of stage I, 2 of stage II, 3 of stage III and 5 of stage IV. Histologically they included 10 cases of choriocarcinoma and 3 of invasise mole. All patients were treated by complete surgical resection combined with subsequent adjuvant chemotherapy.

Conclusions: Misdiagnosis leads to delay in therapy with resultant increased morbidity of GTT. Analysis on serial hCG is helpful to differential diagnosis between ectopic pregnancy and GTT.