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Diagnosis and management of a metastatic mixed gestational trophoblastic neoplasia with synchronous primary lung cancer
  1. Varun Iyengar1,2,
  2. Hetal Mistry1,3,
  3. Catherine Hibbitt3 and
  4. Alexei Shimanovsky1,3
  1. 1Alpert Medical School of Brown University, Providence, Rhode Island, USA
  2. 2Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3Rhode Island Hospital, Providence, Rhode Island, USA
  1. Correspondence to Dr Varun Iyengar; viyengar14{at}gmail.com

Abstract

Mixed gestational trophoblastic neoplasias (GTNs) are rare placental tumours that arise from abnormal fertilisation events. To date, only 34 patients with mixed GTNs have been reported in the literature. As such, the management of such cases remains challenging. This report presents a case of a mixed GTN that was further complicated by a synchronous primary lung adenocarcinoma. Our patient was initially treated with hysterectomy, with surveillance labwork showing persistence of her malignancy. She then began combination chemotherapy, at the end of which she appeared to be in remission clinically. Unfortunately, subsequent imaging showed the persistence of pulmonary nodules that were ultimately resected, demonstrating a new primary lung adenocarcinoma. At present, she remains free of both cancers 2 years after her initial diagnosis. The complexity of this case underscores the importance of patient-centred treatment for rare tumours and the role of a multidisciplinary team in the effort to provide holistic care.

  • gynecological cancer
  • lung cancer (oncology)
  • pathology
  • medical education

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Footnotes

  • Contributors VI designed the report, conducted the literature review and drafted the manuscript. HM contributed and provided feedback on the manuscript; she may be considered a co-first author. CH is the patient described and contributed her perspective to the report. AS conceived of the case report, contributed to its drafting, and critically reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.