Spontaneous Regression Of Pulmonary Metastases Following Hydatidiform Mole
British Journal of Clinical Practice 22(7): July 1968; 305-307
View Original Source →Abstract
As I have tried to tabulate and evaluate the cases of spontaneous regression of gynecologic malignancy, several facts stand out: (1) They were infrequent. (2) The tumors most commonly undergoing spontaneous regression were the germinal epithelial tumors of the ovary; there was not one case of spontaneous regression of any other variety of ovarian neoplasm. (3) There was not one legitimate case of spontaneous regression of an invasive epidermoid carcinoma of the vulva, vagina, or uterus.
Case Details
Personal Characteristics
The patient, aged 24, had a normal delivery in november 1960. She was admitted in december 1961, with vaginal bleeding and amenorrhoea of 18 weeks.
Clinical Characteristics
Examination revealed a 26-weeks uterus. No foetal movements had been felt but with a strong family history of twins, treatment was conservative at first. However, a few days later her blood pressure, which had been normal, rose to 190/110. There was also albuminuria and oedema. Hydatidiform mole was strongly suspected and was confirmed by abdominal x-ray. Abdominal hysterotomy was carried out and the mole evacuated digitally. Both ovaries were enlarged and cystic.
Remission Characteristics
The chest x-rays showed gradual fading of the lung shadows until in july 1962, that is six months after evacuation, when they were reported to be normal. They remain thus, to this day.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Abdominal hysterotomy was carried out and the mole evacuated digitally.
Additional Notes
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.