辅助生殖双胎之一完全性葡萄胎继发妊娠滋养细胞肿瘤、乳腺癌一例

doi:10.3877/cma.j.issn.2095-3259.2022.02.009

中华产科急救电子杂志 ›› 2022, Vol. 11 ›› Issue (02) : 108 -110. doi: 10.3877/cma.j.issn.2095-3259.2022.02.009

病例报告

辅助生殖双胎之一完全性葡萄胎继发妊娠滋养细胞肿瘤、乳腺癌一例

岳琦瑄¹, 叶佩莹², 杨丽帆², 赵卫华¹^,^†(

)

^1. 安徽医科大学深圳二院临床学院　518000；安徽医科大学第五临床学院，合肥　230000；深圳市第二人民医院产科　518000
^2. 深圳市第二人民医院产科　518000

收稿日期:2021-06-10 出版日期:2022-05-18
通信作者: 赵卫华
基金资助:
深圳市科技计划项目(JCYJ20170817172241688)

Gestational trophoblastic tumor and breast cancer secondary to complete mole in one twin after assisted reproductive technology: a case report

Qixuan Yue¹, Peiying Ye², Lifan Yang²

Received:2021-06-10 Published:2022-05-18

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患者31岁，孕3产0，2020年5月19日于外院植入新鲜囊胚2枚，因"停经13⁺¹周，发现双胎之一妊娠囊发育异常10余天"收入深圳市第二人民医院，入院超声检查示双胎之一胎儿存活，约13⁺³周大小(位于宫腔底部)，另一胎儿为完全性葡萄胎(位于宫腔下段)，胎盘下缘完全覆盖宫颈内口；人绒毛膜促性腺激素(human chorionic gonadotrophin，hCG)2 622 160 U/L(正常值<5 U/L)。入院诊断：(1)双胎妊娠(双绒双羊)；(2)双胎之一葡萄胎；(3)孕3产0，妊娠13⁺¹周，宫内单活胎；(4)体外受精-胚胎移植(in vitro fertilization-embryo transfer，IVF-ET)术后；(5)右输卵管切除术后。生育史：患者既往2次右侧输卵管妊娠史，余无特殊。入院后行清宫术，术后病理报告示完全性葡萄胎(图1)。清宫后1周复查β-hCG：10 155 U/L；超声检查示子宫腔内少许积液。行二次清宫术，术后病理：(宫腔组织)符合妊娠物残留，局灶考虑胎盘部位过度反应。术后第2天查β-hCG：8389 U/L，予出院。出院诊断：(1)双胎之一完全性葡萄胎；(2)乳腺结节性质待查；(3)IVF-ET术后；(4)右输卵管切除术后。

图1 辅助生殖双胎之一完全性葡萄胎继发妊娠滋养细胞肿瘤、乳腺癌患者葡萄胎病理切片图(HE×20)

图2 辅助生殖双胎之一完全性葡萄胎继发妊娠滋养细胞肿瘤、乳腺癌患者乳腺癌病理切片图(HE×20)

图3 辅助生殖双胎之一完全性葡萄胎继发妊娠滋养细胞肿瘤、乳腺癌患者血清β-hCG数值变化

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