The ideal treatment for metastatic choriocarcinoma in the lungs in a young women is :
Ans. is a i.e. Chemotherapy "Unlike other malignant lesion, the treatment of choriocarcinoma is mainly chemotherapy, both for local and distant metastasis." Note : Treatment of malignant trophoblastic disease must be continued with repeated courses of combination chemotherapy until p HCG titres return to nondetectable levels. Complete remission is documented after 3 consecutive weekly normal 13 HCG titres It is recommended that all high risk patient should receive at least three courses of triple agent chemotherapy after beta HCG titres have returned to normal Patients with brain or liver metastasis are at great risk of sudden death from hemorrhage from these lesions therefore it is a standard practice to include whole brain or whole liver irradiation concomitantly with combination chemotherapy. Diseases not responsive to EMACO are treated with EPEMA where cisplatin and Etoposide are substituted for cyclophosphamide and vincristine (CO). If the patient does not wish to preserve feility, hysterectomy with adjuvant single agent chemotherapy may be performed as primary treatment. Hysterectomy is also performed in all patients with placental site trophoblastic tumor,
Chemotherapy
Surgery with radiation
Surgery
Wait and watch