Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy
Gestational trophoblastic neoplasia (GTN) consists of rare malignancies of the placenta with a known propensity to metastasize to the lungs. GTN is treated with chemotherapeutic agents known to cause lung injury, further placing patients at risk for serious pulmonary events. In the literature, only...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-08-01
|
| Series: | Gynecologic Oncology Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578923000930 |
| _version_ | 1797753939551059968 |
|---|---|
| author | Hanaa Khadraoui Thomas J. Herzog Amanda Jackson Caroline Billingsley |
| author_facet | Hanaa Khadraoui Thomas J. Herzog Amanda Jackson Caroline Billingsley |
| author_sort | Hanaa Khadraoui |
| collection | DOAJ |
| description | Gestational trophoblastic neoplasia (GTN) consists of rare malignancies of the placenta with a known propensity to metastasize to the lungs. GTN is treated with chemotherapeutic agents known to cause lung injury, further placing patients at risk for serious pulmonary events. In the literature, only a few reports of these complications and their management have been described. Here, we present two cases of GTN with pulmonary complications in the hopes of providing guidance in management. Management of these acute complications had to be balanced between continuation of life-saving therapy to reduce disease burden versus further exacerbation existing pulmonary disease. A review of the English language literature on pulmonary complications in GTN and chemotherapy was performed.In these two cases, we identified key steps that were critical in management: inpatient chemotherapy, early intervention and transfer to an intensive unit when needed, multidisciplinary teams, and altering regimens to reduce lung toxicity. Sequelae of pulmonary injury secondary to chemotherapy can be similar to those secondary to metastases. Because consistent criteria for chemotherapy-induced lung injury has not been established, the true incidence of lung injury that is directly related to chemotherapy versus metastatic disease cannot always be parsed out, making management of these complications difficult. There is also a lack of centralized care for a rare disease like GTN and regional differences in incidence, which can lead to inconsistent treatment decisions. It therefore remains important to illuminate rarely seen complications and their management in the hopes of providing guidance to future clinicians. |
| first_indexed | 2024-03-12T17:26:15Z |
| format | Article |
| id | doaj.art-21cc461186b044d387c8e30fe116b80e |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-03-12T17:26:15Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-21cc461186b044d387c8e30fe116b80e2023-08-05T05:16:12ZengElsevierGynecologic Oncology Reports2352-57892023-08-0148101224Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapyHanaa Khadraoui0Thomas J. Herzog1Amanda Jackson2Caroline Billingsley3University of Cincinnati Department of Obstetrics & Gynecology, 231 Albert Sabin Way MSB 4408, Cincinnati, OH 45267, USA; Corresponding author at: 231 Albert Sabin Way, MSB 4408, Cincinnati, OH 45267, USA.University of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USAUniversity of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USAUniversity of Cincinnati Department of Obstetrics & Gynecology: Division of Gynecologic Oncology, 234 Goodman Street, Cincinnati, OH 45219, USAGestational trophoblastic neoplasia (GTN) consists of rare malignancies of the placenta with a known propensity to metastasize to the lungs. GTN is treated with chemotherapeutic agents known to cause lung injury, further placing patients at risk for serious pulmonary events. In the literature, only a few reports of these complications and their management have been described. Here, we present two cases of GTN with pulmonary complications in the hopes of providing guidance in management. Management of these acute complications had to be balanced between continuation of life-saving therapy to reduce disease burden versus further exacerbation existing pulmonary disease. A review of the English language literature on pulmonary complications in GTN and chemotherapy was performed.In these two cases, we identified key steps that were critical in management: inpatient chemotherapy, early intervention and transfer to an intensive unit when needed, multidisciplinary teams, and altering regimens to reduce lung toxicity. Sequelae of pulmonary injury secondary to chemotherapy can be similar to those secondary to metastases. Because consistent criteria for chemotherapy-induced lung injury has not been established, the true incidence of lung injury that is directly related to chemotherapy versus metastatic disease cannot always be parsed out, making management of these complications difficult. There is also a lack of centralized care for a rare disease like GTN and regional differences in incidence, which can lead to inconsistent treatment decisions. It therefore remains important to illuminate rarely seen complications and their management in the hopes of providing guidance to future clinicians.http://www.sciencedirect.com/science/article/pii/S2352578923000930 |
| spellingShingle | Hanaa Khadraoui Thomas J. Herzog Amanda Jackson Caroline Billingsley Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy Gynecologic Oncology Reports |
| title | Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| title_full | Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| title_fullStr | Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| title_full_unstemmed | Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| title_short | Acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| title_sort | acute pulmonary complications in the setting of high risk gestational trophoblastic neoplasia and induction of chemotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2352578923000930 |
| work_keys_str_mv | AT hanaakhadraoui acutepulmonarycomplicationsinthesettingofhighriskgestationaltrophoblasticneoplasiaandinductionofchemotherapy AT thomasjherzog acutepulmonarycomplicationsinthesettingofhighriskgestationaltrophoblasticneoplasiaandinductionofchemotherapy AT amandajackson acutepulmonarycomplicationsinthesettingofhighriskgestationaltrophoblasticneoplasiaandinductionofchemotherapy AT carolinebillingsley acutepulmonarycomplicationsinthesettingofhighriskgestationaltrophoblasticneoplasiaandinductionofchemotherapy |