Browsing by Author "Lazić, Jelena (57217223433)"

Patient with malignant Gestational Trophoblastic Neoplasm (GTN) was treated by mean of MTX-FA, MAC, EMA-CO and EMA-EP. Changes in serum human chorionic gonadotropine (beta hCG) levels and changes in ultrasonographic findings were checked weekly. Finally transabdominal hysterectomy with ovaries conservation was done and polychemotherapy administrated after the operation until three consecutive serum chorionic gonadotropine values were negative. This is a case report of Invasive mole in 32 years old patient without possibillity to preserve reproductive health. GTN developed two months after spontaneous abortion in 13th week gestation. No changes in uterine structure were found during the first ultrasonographic examination. Th ree months after abortion and one month after GTN confirmed, massive destruction of lateral uterine wall was detected during transvaginal Doppler ultrasound examination. Resistance index of 0,366 was significantly lower than normal, with hypervascularisation in affected tissue. Serum beta hCG confirmed poor effect of polychemotherapy treatment and decision for operative treatment was made. Hystological findings after the operation confirmed malignant GTN-invasive mole. Specific changes in ultrasonographic picture could have an impact in therapy making decision and could not be refereed without the most relevant parameter such is serum human chorionic gonadotropine.

Laboratory findings such are white blood count and sedimentation rate are of relative value in inflammations of the upper genital tract and adnexal inflammatory tumors. Antibiotics are administrated in all cases according to the protocol but some of them need operative treatment also. Inflammatory tumors can develop in endometriotic and even in cancer adnexal masses. CA 125 is elevated in great number of patients with advanced ovarian cancer. It can also be elevated in endometriosis, inflammations and in non-gynecological malignancies. Adnexal inflammatory tumor was confirmed in 57 patients. Laboratory findings: white blood count and sedimentation rate were in normal levels in 17 patients. CA 125 was elevated in 27 patients. 49 patients were operated and CA 125 decreased in the first 5 days after the operation. Only 8 patients without CA 125 elevation were successfully treated by mean of antibiotics. Even there is no need for routine examining of serum CA 125 in adnexal inflammatory tumors it can be examined in cases with suspected Doppler ultrasonographic findings or unclear clinical findings. Endometriosis brings some risk of malignancy. Inflammatory tumor can develop in endometriotic tumor as well as in necrotic malignant ovary tissue. These could be reasons for making decision to do the operation in cases with inflammatory tumor followed with increased CA 125, hystological assessment and serious interpretation of final results.