分娩を先行妊娠とする絨毛癌

概要

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Choriocarcinoma derived from the pregnancy previous to the delivery is found a little more often in Europe and America than in Japan as indicated in the incidence of 7.3 to 37.1%. Different from the management of hydatidiform mole, choriocarcinoma is very difficult in the corresponding control and, further, it has a tendency to increase in the incidence, compared with choriocarcinoma following the hydatidiform mole. To explain the pathogenesis of this cancer, the following can be considered : (1) The outbreak due to the villus of a retained placenta, (2) The onset of primary choriocarcinoma in a normal placenta at the end of pregnancy period. For detecting the cancer, there are no other methods than the scrutiny of the placenta at delivery and the notice of an abnormal postpartum bleeding.<BR>Two cases lately experienced were non-metastatic choriocarcinoma after the delivery, detected in a comparatively early stage. The chemical treatment with the use of both methotrexate and actinomycin D was conducted for these patients before the excision of the uterus.<BR>In both cases, no abnormalities have been found for 15 months and 9 months after the operation respectively. On this occasion, our views on choriocarcinoma derived from the pregnancy previous to the delivery have been described, based on the actual experience and the knowledge through the literature.
学校法人昭和大学・昭和医学会の論文