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Choriocarcinoma Presented as Chronic Gastrointestinal Bleeding

以慢性腸胃道出血爲初期表徵的絨毛膜癌

摘要


一位38歲的女性病人發生間歇性黑便達一個多月。檢查結果顯示爲富含血管之腫瘤,合併肝、脾、小腸、腎藏及腦部轉移。初次之婦科檢查無特殊發現。病人隨後因脾藏破裂,進行緊急外科手術,包括部份空腸、部份左腎及脾藏之切除。外科標本之病理切片診斷爲絨毛膜癌。經過密集化學及放射線治療後,病人血清之絨毛膜素由850,000 mIu/ml下降至正常。手術十個月後之追蹤檢查發現,病人血清之絨毛膜素仍在正常範圍,肝、腎、腦部及腸胃道並未出現顯之轉移病灶。

並列摘要


A 37-year-old multi-para patient presented an intermittent tarry stool passage for one month. A series of examinations revealed hypervascular tumors in liver, spleen, small intestine, kidneys and brain metastases. Gynecological examination was negative initially. The patient received surgical intervention kidney because of spleen ruptrue and chronic gastrointestinal bleeding. Pathological examination of the resected tumors from spleen, jejunum and kidney revealed choriocarcinoma. Serum beta-HCG decreased from 850,000 mIU/ml soon after operation to normal after intensive chemotherapy and radiotherapy. Remission of the metastatic choriocarcinoma and normal serum beta-HCG level still were noted 10 months after the operation.

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