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Gestational trophoblastic neoplasm in a patient with end-stage renal failure (ESRF): the challenges and lessons learnt
  1. Kanddy Chin Yee Loo1,
  2. Yueh Ni Lim2,
  3. Doreen Kher Lee Kiu2 and
  4. Wee Wee Sim1
  1. 1Obstetric and Gynaecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia
  2. 2Radiotherapy Unit, Sarawak General Hospital, Kuching, Sarawak, Malaysia
  1. Correspondence to Dr Kanddy Chin Yee Loo; klcygirl{at}


Gestational trophoblastic neoplasm (GTN) in end-stage renal failure (ESRF) has not been reported. We reported an unprecedented case of GTN in ESRF from an antecedent partial mole. She had total abdominal hysterectomy and bilateral salpingectomy following the diagnosis as the disease was confined to the uterus. A histopathological examination confirmed an invasive mole. Consequently, she received a total of four cycles of single-agent intravenous actinomycin D as she was at low risk. Despite initial response, her disease metastasised to her right kidney for which radiotherapy was given, followed by a total of 33 doses of weekly paclitaxel. She responded to the chemotherapy and currently remains in remission. The choice of chemotherapy and their side effects due to ESRF remain the main challenges in her management. Total hysterectomy should be considered as the first-line treatment for a hydatidiform mole to prevent GTN. A multidisciplinary approach is important to optimise the efficacy of the treatment with minimal compromise of her safety.

  • Gynecological cancer
  • Dialysis

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  • Contributors KCYL conceived the idea of writing and publishing this case report. KCYL and DKLK did the literature search and wrote the manuscript. YNL and WWS reviewed and revised the final manuscript for publishing.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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