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phantom hcg

Jennifer Goldstein, Prasamsa Pandey, Nicole Fleming, Shannon Westin, Sarina Piha-Paul
There is a broad range of possible diagnoses for an elevated beta human chorionic gonadotropin (β-hCG) in the absence of intrauterine or ectopic pregnancy. When women of child bearing potential undergo evaluation for clinical trial, it is often unclear what course of evaluation to take when a pregnancy test is positive. We describe the clinical course of a patient with widely metastatic mucinous ovarian carcinoma with metastasis to the peritoneum, lymph nodes and liver. The patient was found to have a mildly elevated β-hCG during initial evaluation for clinical trial...
August 2016: Gynecologic Oncology Reports
B González Aguilera, P Syrios, R Gadisseur, F Luyckx, E Cavalier, A Beckers, H Valdes-Socin
Phantom hCG refers to persistent mild elevations of hCG, leading physicians to unnecessary treatments whereas neither a true hCG nor a trophoblastic disease is present. We report the case of a 23-year-old woman with persistent low levels of serum hCG detected one month after miscarriage. As choriocarcinoma was suspected, a chemotherapy trial of methotrexate was prescribed, without any hCG reduction. Subsequently, laparoscopy ruled out a trophoblastic residue and the patient was referred to the Endocrine Unit for further investigations...
June 2016: Gynecological Endocrinology
Inge M W Ebisch, Gijs J M Limonard, Willem Vreuls, Jan M J Sporken
BACKGROUND: If a positive pregnancy test is followed by profuse vaginal bleeding, the diagnosis of miscarriage can generally be made. Sometimes, however, elevated hCG levels may be associated with a phantom pregnancy, which may be a paraneoplastic symptom. CASE DESCRIPTION: A 27-year-old woman was referred for a diagnosis after having experienced 3 consecutive miscarriages. The diagnostic workup could not identify an underlying cause. After 3 more biochemical miscarriages, the original diagnosis was called into question and extensive testing for ectopic hCG production was performed...
2013: Nederlands Tijdschrift Voor Geneeskunde
Shigeru Sasaki, Yasushi Sasaki, Koichi Iino
BACKGROUND: In Japan there are no reported cases of phantom human chorionic gonadotropin (hCG) or quiescent gestational trophoblastic disease (GTD). GTD is managed well in Japan according to Japanese guidelines for the treatment of GTD, and we have almost conquered this disease during recent decades. Furthermore, the incidence of GTD is decreased today, associated with the decrease of birth rate in Japan. Many young doctors now have little opportunity to see typical classic mole and participate in the management of GTD during their residency training...
July 2010: Journal of Reproductive Medicine
Ross S Berkowitz, Donald P Goldstein
OBJECTIVES: This review was undertaken to describe current understanding of the natural history of molar pregnancy and persistent gestational trophoblastic neoplasia (GTN) as well as recent advances in their management. MATERIALS AND METHODS: Recent literature related to molar pregnancy and GTN was thoroughly analyzed to provide a comprehensive review of the current knowledge of their pathogenesis and treatment. RESULTS: Studies in patients with familial recurrent molar pregnancy indicate that dysregulation of parentally imprinted genes is important in the pathogenesis of complete hydatidiform mole (CHM)...
March 2009: Gynecologic Oncology
M Zavadil, J Feyereisl, L Krofta, P Safár, R Turyna
OBJECTIVE: To define persistent trophoblastic disease as a clinical entity of gestational trophoblastic disease. To describe its classification, treatment and follow-up. TYPE OF STUDY: Retrospective analysis. SETTING: Trophoblastic Disease Center (TDC) in the Czech Republic TDC-CZ, Institute for the Care of Mother and Child, Prague. METHODS: This study analyzes data from the Trophoblastic Disease Center consisting of 396 choriocarcinomas, 512 proliferative moles, 798 complete hydatid moles, 1299 partial hydatid moles, and 2105 persistent trophoblastic invasions treated at the TDC up to the year 2007...
April 2008: Ceská Gynekologie
Akitoshi Takizawa, Takeshi Kishida, Takeshi Miura, Yusuke Hattori, Kazumi Noguchi, Yoshinobu Kubota
PURPOSE: The finding of an unexplainable persistent low level of serum human chorionic gonadotropin in the management of testicular cancer sometimes misleads physicians. To avoid unnecessary treatment we suggest a new classification and algorithm for testicular germ cell tumors to discriminate real human chorionic gonadotropin from false-positive results. MATERIALS AND METHODS: A total of 24 patients who seemed to have no cancer with an increased but low level of serum human chorionic gonadotropin were evaluated...
March 2008: Journal of Urology
Luis Rojas-Espaillat, Karen L Houck, Enrique Hernandez, Ross S Berkowitz
BACKGROUND: Persistently low-level "real" serum human chorionic gonadotropin (hCG) after treatment for gestational trophoblastic neoplasia (GTN) in patients desirous of preserving fertility is a diagnostic and management challenge. Among the possible explanations is the presence of false positive ("phantom") hCG or of trophoblasts in a myometrial sanctuary. CASE: An 18-year-old woman had persistent low-level hCG values in her serum after treatment for nonmetastatic GTN...
May 2007: Journal of Reproductive Medicine
Allan Covens, Virginia L Filiaci, Robert A Burger, Raymond Osborne, M Dwight Chen
BACKGROUND: The purpose of the study was to determine the activity and toxicity of pulse dactinomycin as salvage treatment of patients with low-risk gestational trophoblastic neoplasia (GTN) who failed methotrexate therapy. METHODS: Eligible patients had persistent/recurrent low-risk GTN defined by changes in serum human chorionic gonadotropin (hCG) levels (<10% fall over 3 consecutive weekly titers, >20% rise over the previous value, or a rise after attaining institutional normal [>5 mu/mL]); World Health Organization (WHO) score 2-6; Gynecologic Oncology Group (GOG) performance status 0-1; and previous treatment restricted to methotrexate...
September 15, 2006: Cancer
M Zavadil, J Feyereisl, P Safár, M Pán, R Turyna
OBJECTIVE: To analyze the syndrome of persistent low levels of hCG in terms of its etiology, classification, diagnosis, and management. DESIGN: Retrospective analysis. SETTING: Center for Trophoblastic Disease in Czech Republic, Institute for Care of Mother and Child, Prague, Institute of Postgraduate medical education, IPVZ, Prague METHODS: An analysis of the syndrome of persistent low levels of hCG recorded in CTN in 29 women in the years 1979-2005 by the immunoluminesence method which can quantitatively assess variable levels of hCG in blood and urine...
March 2006: Ceská Gynekologie
Katsuyoshi Seki, Hideo Matsui, Souei Sekiya
BACKGROUND: Gestational trophoblastic disease (GTD) consists of a spectrum of disorders that are characterized by an abnormal proliferation of trophoblastic tissue. Gestational trophoblastic neoplasia (GTN) refers to a subset of GTD with a persistently elevated serum hCG in the absence of a normal pregnancy and with a history of normal or abnormal pregnancy. Although previously a lethal disease, GTN is considered today the most curable gynecologic cancer. However, a delay in the diagnosis may increase the patient's risk of developing malignant GTN, and therefore the prompt identification of GTN is important...
November 2004: Clinica Chimica Acta; International Journal of Clinical Chemistry
Piotr Skałba, Katarzyna Gajewska, Anna Bednarska-Czerwińska
In the human blood and urine there are different antigen forms of choriogonadotropin including nonnicked hCG, nicked hCG, free subunit, free subunit, nicked free, core fragment hCG, hyperglycosylated hCG, nicked hCG missing the subunit C-terminal peptide, asialo hCG, residues 92-145, alternatively nicked hCG--cleaved at 43-44 or 44-45 and others. The authors discuss the value of hCG measurements in the diagnosis of normal pregnancy, pathological pregnancy, Down syndrome screening and oncology: gestational trophoblastic disease, testicular, bladder, digestive tract and other cancers...
March 2004: Ginekologia Polska
T Y Ng, L C Wong
The FIGO Committee Report on the FIGO 2000 staging for gestational trophoblastic disease included criteria for the diagnosis of gestational trophoblastic neoplasia (GTN). It recommended investigative tools for diagnosing metastases. Anatomical and prognostic indicators were combined into a stage : risk score to stratify patients into low and high-risk groups. This is the first staging system to incorporate inclusive criteria that are likely to be adopted universally. The diagnostic evaluation of GTN is presented...
December 2003: Best Practice & Research. Clinical Obstetrics & Gynaecology
Ernest I Kohorn
OBJECTIVE: The finding of persistent low-level human chorionic gonadotropin (hCG) with or without a preceding pregnancy event presents a rare but clinically important challenge and a therapeutic dilemma. These are patients with "real" hCG shown by the positive test in both serum and urine or by specialized testing. The problems associated with "phantom" hCG have been recognized and should now be clinically resolvable. Four cases of low-level "real" hCG are described to illustrate the problems encountered, the management, and the resolution achieved...
May 2002: Gynecologic Oncology
L A Cole
Phantom hCG and phantom choriocarcinoma syndrome (pseudohypergonadotropinemia) refers to persistent mild elevations of hCG, leading physicians to treat patients with cytotoxic chemotherapy for choriocarcinoma when in reality no true hCG or trophoblast disease is present. We report here three cases of the phantom hCG and phantom choriocarcinoma syndrome referred to the hCG Reference Service. In the first case, low levels of hCG were detected in serum (49 to 89 IU/liter) 11 months after the patient had a miscarriage...
November 1998: Gynecologic Oncology
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