{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:11:50Z","timestamp":1776867110344,"version":"3.51.2"},"reference-count":9,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,5,8]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>Gestational trophoblastic neoplasm (GTN) in end-stage renal failure (ESRF) has not been reported. We reported an unprecedented case of GTN in ESRF from an antecedent partial mole. She had total abdominal hysterectomy and bilateral salpingectomy following the diagnosis as the disease was confined to the uterus. A histopathological examination confirmed an invasive mole. Consequently, she received a total of four cycles of single-agent intravenous actinomycin D as she was at low risk. Despite initial response, her disease metastasised to her right kidney for which radiotherapy was given, followed by a total of 33 doses of weekly paclitaxel. She responded to the chemotherapy and currently remains in remission. The choice of chemotherapy and their side effects due to ESRF remain the main challenges in her management. Total hysterectomy should be considered as the first-line treatment for a hydatidiform mole to prevent GTN. A multidisciplinary approach is important to optimise the efficacy of the treatment with minimal compromise of her safety.<\/jats:p>","DOI":"10.1136\/bcr-2022-249474","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T11:40:49Z","timestamp":1652874049000},"page":"e249474","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Gestational trophoblastic neoplasm in a patient with end-stage renal failure (ESRF): the challenges and lessons learnt"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3739-7465","authenticated-orcid":false,"given":"Kanddy Chin Yee","family":"Loo","sequence":"first","affiliation":[{"name":"Obstetric and Gynaecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh Ni","family":"Lim","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Sarawak General Hospital, Kuching, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen Kher Lee","family":"Kiu","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Sarawak General Hospital, Kuching, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wee Wee","family":"Sim","sequence":"additional","affiliation":[{"name":"Obstetric and Gynaecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"2025082708234137000_15.5.e249474.1","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/S1521-6934(03)00097-X","article-title":"Management of gestational trophoblastic disease in developing countries","volume":"17","author":"Sivanesaratnam","year":"2003","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2025082708234137000_15.5.e249474.2","first-page":"e1","article-title":"Management of gestational trophoblastic disease","volume":"128","author":"Tidy","year":"2021","journal-title":"BJOG"},{"key":"2025082708234137000_15.5.e249474.3","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds344"},{"key":"2025082708234137000_15.5.e249474.4","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdp598"},{"key":"2025082708234137000_15.5.e249474.5","unstructured":"Ashley C , Currie A . The renal drug Handbook. Third Edition. Radcliffe Publishing Ltd, 2009."},{"key":"2025082708234137000_15.5.e249474.6","first-page":"81","article-title":"Clinical dilemma over low-dose methotrexate therapy in dialysis patients: a case report and review of literature","volume":"8","author":"Liu","year":"2014","journal-title":"Iran J Kidney Dis"},{"key":"2025082708234137000_15.5.e249474.7","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1996.0110"},{"key":"2025082708234137000_15.5.e249474.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-018-5168-x","article-title":"Total hysterectomy versus uterine evacuation for preventing post-molar gestational trophoblastic neoplasia in patients who are at least 40\u2009years old: a systematic review and meta-analysis","volume":"19","author":"Zhao","year":"2019","journal-title":"BMC Cancer"},{"key":"2025082708234137000_15.5.e249474.9","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1097\/AOG.0000000000001554","article-title":"Second curettage for low-risk nonmetastatic gestational trophoblastic neoplasia","volume":"128","author":"Osborne","year":"2016","journal-title":"Obstet Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-249474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:23:49Z","timestamp":1756308229000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-249474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5,18]]},"published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1136\/bcr-2022-249474"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-249474","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}