Some Aspects of Chorion Epithelioma | Spontaneous Remission Database

Abstract

A case is reported where pulmonary metastases were found in a case of benign hydatidiform mole. The metastases regressed spontaneously without any treatment. It is suggested that chest X-rays and estimations of chorionic gonadotrophins in the urine should be carried out at regular intervals. It is well known that pulmonary metastases can occur in cases of benign hydatidiform moles, but it is not always accepted that they can regress without any treatment. This case is reported as it all happened some years ago and the patient is still alive and well.

Case Details

Personal Characteristics

The patient, aged 30 years, had had 5 normal labours, the last 38 days before her admission to hospital

Clinical Characteristics

2 secondary chorionepitheliomata of the vulva, one on the perineum, 3.5 centimeters in diameter, and the other involving the left side of the vestibule and the urethral orifice, 3 centimeters by 2 centimeters. A hemorrhagic mass 3.5 by 1.5 centimeters was attached to the fundus of the uterus and projected into its lumen.

Remission Characteristics

7 days after the operation it had undergone spontaneous regression to about one-third of its original size and at the end of 14 days it was represented by a thickening about the size of a split pea. Twenty-four days after the operation there was no visible or palpable evidence of its existence.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

I performed an abdominal panhysterectomy, removing both fallopian tubes and ovaries. I excised the posterior vulval mass. The anterior vulvo-vaginal secondary was not excised as it was involving the urethra, but it was intended to treat it with radium as soon as the patient was convalescent from the abdominal operation.

Additional Notes

The concentration of urine gonadotrophin fell rapidly after the operation and at the end of 6 weeks it was positive in undiluted urine but negative in a dilution of 1/10. Nine weeks postoperatively it was negative in undiluted urine and has remained negative ever since. The last test was carried out 1 month ago, that is 11 years and 3 months after the operation. At this time the patient and the child of the relevant pregnancy were both in excellent health.