旨在阐明一组特殊的妊娠滋养细胞肿瘤 (GTN) 患者的临床病理学特征和肿瘤学结果，这些患者最初表现为孤立性肺部病变、人绒毛膜促性腺激素 (hCG) 水平升高和未观察到的盆腔病变。总共有 2358 名 GTN 患者在对我院2000年至2023年期间的病例进行回顾性分析，评估患者40例。收集每位患者的人口统计学特征、临床病理特征、治疗数据和随访信息。主要结局是无进展生存期。采用Kaplan-Meier分析以及​​单变量和多变量Cox比例风险分析来确定危险因素。在40名患者中，95.0%有孤立性肺部病变，中位尺寸为1.9厘米。此外，72.5%的患者经病理证实为上皮样滋养细胞肿瘤（ETT）。在中位随访时间为 53.5 个月（范围为 2-143）期间，11 名患者出现复发，包括所有仅接受化疗作为初始治疗的患者，并且没有观察到死亡。复发治疗包括肺段切除术和肺叶切除术联合化疗和免疫治疗。单变量和多变量 Cox 分析确定，与手术±化疗相比，单独化疗作为初始治疗（风险比 [HR] =7.738，95% 置信区间 [CI] 1.698-35.269，P = 0.008）是复发的独立危险因素。对于有妊娠史且表现出孤立性肺部病变、hCG 水平升高（大多<1000 mIU/mL）以及未观察到的盆腔病变的患者，应首先考虑 ETT。手术切除肺部病变对于最佳治疗至关重要。当考虑化疗时，建议采用多种药物治疗方案。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions.Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors.Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2-143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698-35.269, P = 0.008) as independent risk factor for recurrence.In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly <1000 mIU/mL), and unobserved pelvic lesions, ETT should be considered first. Surgical resection of lung lesion is crucial for optimal management. When chemotherapy is considered, multidrug regimen is recommended.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.