Macroscopic hematuria as a presentation of gestational trophoblastic neoplasia in an adolescent woman


Gestational trophoblastic neoplasia (GTN) is a hemorrhagic malignancy with highly rapid potential metastasis via hematogenous spreading. Renal metastasis is of infrequent occurrence. Among previous case reports of renal metastasis in GTN, this is the youngest woman presenting a large renal lesion concurrent with pulmonary and brain metastases. Disease remission had been achieved by treatment with combined chemotherapy and whole brain radiation, although acute myeloblastic leukemia (AML) developed later.

Share and Cite:

Ruengkhachorn, I. , Phithakwatchara, N. and Chatchotikawong, U. (2013) Macroscopic hematuria as a presentation of gestational trophoblastic neoplasia in an adolescent woman. Health, 5, 35-38. doi: 10.4236/health.2013.57A4005.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Berkowitz, R.S. and Goldstein, D.P. (2009) Current management of gestational trophoblastic diseases. Gynecologic Oncology, 112, 654-662. doi:10.1016/j.ygyno.2008.09.005
[2] Soper, J.T. (1995) Identification and management of high-risk gestational trophoblastic disease. Seminars in Oncology, 22, 172-184.
[3] Soper, J.T., Mutch, D.G., Chin, N., Clarke-Pearson, D.L. and Hammond, C.B. (1988) Renal metastases of gestational trophoblastic disease: A report of eight cases. Obstetrics and Gynecology, 72, 796-798.
[4] Kutcher, R., Lu, T., Gordon, D.H. and Becker, J.A. (1977) Renal choriocarcinoma metastasis: A vascular lesion. American Journal of Roentgenology, 128, 1046-1048. doi:10.2214/ajr.128.6.1046
[5] Vijay, R.K., Kaduthodil, M.J., Bottomley, J.R. and Abdi, S. (2008) Metastatic gestational trophoblastic tumour presenting as spontaneous subcapsular renal haematoma. British Journal of Radiology, 81, e234-e237. doi:10.1259/bjr/81495647
[6] Yang, D.M., Yoon, M.H., Kim, H.S. and Shin, D.B. (2000) Intrarenal pseudoaneurysms complicating renal choriocarcinoma metastases: Treatment with coil embolization. Clinical Imaging, 24, 217-220. doi:10.1016/S0899-7071(00)00220-5
[7] Chakrabarti, J., Mishra, P.K., Mondal, P., Ghosh, D., Chaterjee, R.G. and Ghosh, D.K.G. (2006) Metastatic choriocarcinoma presenting as a renal mass. Indian Journal of Medical & Paediatric Oncology, 27, 47-49.
[8] Ghaemmaghami, F. and Ashraf-Ganjoie, T. (2006) Metastatic gestational trophoblastic neoplasms and no gynecological symptoms: Report of five cases. Acta Medica Iranica, 46, 77-80.
[9] Tai, K.S., Chan, F.L. and Ngan, H.Y. (1998) Renal metastasis from choriocarcinoma: MRI appearance. Abdominal Imaging, 23, 536-538. doi:10.1007/s002619900395
[10] Wang, Y. (1991) Clinicopathological study on 31 cases of renal metastasis of choriocarcinoma. Zhonghua Yi Xue Za Zhi, 71, 514-515.
[11] Mack, R.B., Katz, S.M. and Amenta, P.S. (1992) Choriocarcinoma of the kidney. Journal of the American Osteopathic Association, 92, 799-802.
[12] Jones, W.B. and Lewis Jr., J.L., (1974) Treatment of gestational trophoblastic disease. American Journal of Obstetrics & Gynecology, 120, 14-20.
[13] Song, H.Z., Wu, B.Z., Tang, M.Y., Wang, Y.E. and Yang, X.Y. (1984) A staging system of gestational trophoblastic neoplasms based on the development of the disease. Chinese Medical Journal (England), 97, 557-566.
[14] Mazur, M.T., Lurain, J.R. and Brewer, J.I. (1982) Fatal gestational choriocarcinoma. Clinicopathologic study of patients treated at a trophoblastic disease center. Cancer, 50, 1833-1846. doi:10.1002/1097-0142(19821101)50:9<1833::AID-CNCR2820500930>3.0.CO;2-4
[15] Lal, A., Singhal, M., Kumar, S., Bag, S., Singh, S.K. and Khandelwal, N. (2009) Bilateral renal and jejunal metastasis of choriocarcinoma presenting as spontaneous renal hemorrhage. Cancer Imaging, 9, 56-58. doi:10.1102/1470-7330.2009.0010
[16] Ogunbiyi, O.A., Enweren, E.O. and Ogunniyi, J.O. (1986) Unusual renal manifestations of choriocarcinoma. African Journal of Medicine and Medical Science, 15, 93-97.
[17] Regis, C., Taieb, S., Lesoin, A., Baranzelli, M.C., Blehaut, T. and Leblanc, E. (2006) Uncommon clinical presentation of a gestational choriocarcinoma. Gynécologie Obstétrique & Fertilité, 34, 716-719. doi:10.1016/j.gyobfe.2006.05.005
[18] Rustin, G.J., Newlands, E.S., Lutz, J.M., Holden, L., Bagshawe, K.D., Hiscox, J.G., et al. (1996) Combination but not single-agent methotrexate chemotherapy for gestational trophoblastic tumors increases the incidence of second tumors. Journal of Clinical Oncology, 14, 2769-2773.
[19] Hershman, D., Neugut, A.I., Jacobson, J.S., Wang, J., Tsai, W.Y., McBride, R., et al. (2007) Acute myeloid leukemia or myelodysplastic syndrome following use of granulocyte colony-stimulating factors during breast cancer adjuvant chemotherapy. Journal of the National Cancer Institute, 99, 196-205. doi:10.1093/jnci/djk028
[20] Lyman, G.H., Dale, D.C., Wolff, D.A., Culakova, E., Poniewierski, M.S., Kuderer, N.M., et al. (2010) Acute myeloid leukemia or myelodysplastic syndrome in randomized controlled clinical trials of cancer chemotherapy with granulocyte colony-stimulating factor: A systematic review. Journal of Clinical Oncology, 28, 2914-2924. doi:10.1200/JCO.2009.25.8723

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.