CAJ | 학술논문

目的：探讨妊娠滋养细胞肿瘤肾转移的临床表现、影像学表现及治疗方案。方法回顾性分析一例以肾脏自发破裂出血为临床表现的侵袭性葡萄胎患者的病史、辅助检查及诊治经过。结果治疗前患者滋养细胞肿瘤病灶全身多处转移，经依托泊苷、甲氨喋呤、放线菌素-D、长春新碱及环磷酰胺联合鞘内化疗及手术切除子宫及左肾后β-人绒毛膜促性腺激素（Beta human chorionic gonadotrophin,β-HCG）降至正常，影像学检查原转移病灶均吸收好转。结论妊娠滋养细胞肿瘤全身转移引起转移灶出血，该疾病对以上化疗敏感，适时手术可提高患者的治疗效果。
목적：탐토임신자양세포종류신전이적림상표현、영상학표현급치료방안。방법회고성분석일례이신장자발파렬출혈위림상표현적침습성포도태환자적병사、보조검사급진치경과。결과치료전환자자양세포종류병조전신다처전이，경의탁박감、갑안첩령、방선균소-D、장춘신감급배린선알연합초내화료급수술절제자궁급좌신후β-인융모막촉성선격소（Beta human chorionic gonadotrophin,β-HCG）강지정상，영상학검사원전이병조균흡수호전。결론임신자양세포종류전신전이인기전이조출혈，해질병대이상화료민감，괄시수술가제고환자적치료효과。
Gestational trophoblastic tumors (GTTs) are malignant lesions that often cause abnormal genital bleeding and may present with hemoptysis, intraperitoneal bleeding or acute neurologic deficits. GTTs are generally highly chemosensitive with more favorable outcomes than other comparable malignancies. Here we report a rare case of invasive mole (FIGO stage IV, WHO score16) presenting with renal subcapsular hematoma due to bleeding renal metastasis. The patient had a pretreatmentβ-human chorionic gonadotrophin (β-HCG) level of 462 047 mIU/ml and received combined chemotherapy with etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine with also adjuvant surgeries including hysterectomy and nephrectomy. The patient recovered well and the tumor has remained in complete remission for one year and a half.