Recurrent Post-Abortion Gestational Trophoblastic Neoplasia Successfully Treated with TP/TE: A Case Report

Denis Afriansyah, Adhi Pribadi, Budi Handono, Siti Salima, Aisyah Shofiatun Nisa, Muhamad Rinaldi Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital-Padjadjaran University, Bandung, IndonesiaCorrespondence: Denis Afriansyah, Department of Obstetrics and Gynecology, Hasan Sadikin General Hospital-Padjadjaran University, Jl. Pasteur No. 38, Kel. Pasteur, Kec. Sukajadi, Bandung, 40161, Indonesia, Tel +62 822 3984 4705, Email denis21003@mail.unpad.ac.idIntroduction: Gestational trophoblastic neoplasia (GTN) is a highly curable malignancy, but cases arising after abortion are uncommon and often diagnosed late. We report a recurrent high-risk GTN following abortion that relapsed multiple times despite etoposide–methotrexate–actinomycin D/cyclophosphamide–vincristine (EMA/CO).Case Report: A 26-year-old woman achieved initial remission with six cycles of EMA/CO but experienced several recurrences from 2021 to 2023. She presented again with rising β-hCG (16,925.8 mIU/mL) and an intrauterine mass. Paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE) was given for six cycles plus two consolidation cycles, resulting in complete remission. β-hCG normalized by January 2024 and remained undetectable for 12 months.Conclusion: This case highlights diagnostic challenges of post-abortion GTN and shows that TP/TE is an effective and well-tolerated salvage option for recurrent or EMA/CO-resistant GTN. Long-term β-hCG surveillance is essential to ensure durable remission and assess fertility outcomes.Keywords: gestational trophoblastic neoplasia, abortion, β-hCG, recurrence, salvage chemotherapy