Membuat Diagnosis Gestational Trophoblastik Neoplasia: Apa, Kapan, Bagaimana Cara Mengobati dan Apa yang Harus Dilakukan Selanjutnya?

Objective : Delay on diagnosing GTN may increase the GTN score from low risk become high risk, as follow. Methods : case report Results : Mrs I, 29 yo, P1A7 came with vaginal bleeding. Four months before admission, she had surgery of ectopic pregnancy, and the left salphynx and ovary had already taken out. No histopathology examination was performed. After the surgery, she had vaginal bleeding and underwent curettage, but the tissue was not sent for histopathology exam. US exam one week after procedure shows mass protruding in the uterine, with BhCG 225.000 IU/ml. The patient was planned to undergo chemotherapy. While waiting for chemotherapy, patient complaints of acute abdomen due to hemoperitoneum due to perforation of trophoblastic mass. Emergency laparotomy was performed. Conclusions : Inadequate treatment due to inadequate staging is the most common reason for unsuccessful GTN treatment, and increase patient morbidity. Histopathology result also plays an important role to decide the mode of treatment should be given since PSTT and ETT treatment of choice is not using chemotherapy.