ABSTRACT Purpouse: One of the many artificial intelligence based tools that has gained popularity is the Chat-Generative Pre-Trained Transformer (ChatGPT). Due to its popularity, incorrect information provided by ChatGPT will have an impact on patient misinformation. Furthermore, it may cause misconduct as ChatGPT can mislead physicians on the decision-making pathway. Therefore, the aim of this study is to evaluate the accuracy and reproducibility of ChatGPT answers regarding urological diagnoses. Materials and Methods: ChatGPT 3.5 version was used. The questions asked for the program involved Primary Megaureter (pMU), Enuresis and Vesicoureteral Reflux (VUR). There were three queries for each topic. The queries were inserted twice, and both responses were recorded to examine the reproducibility of ChatGPT's answers. Afterwards, both answers were combined. Finally, those rwere evaluated qualitatively by a board of three specialists. A descriptive analysis was performed. Results and Conclusion: ChatGPT simulated general knowledge on the researched topics. Regarding Enuresis, the provided definition was partially correct, as the generic response allowed for misinterpretation. For VUR, the response was considered appropriate. For pMU it was partially correct, lacking essential aspects of its definition such as the diameter of the dilatation of the ureter. Unnecessary exams were suggested, for Enuresis and pMU. Regarding the treatment of the conditions mentioned, it specified treatments for Enuresis that are ineffective, such as bladder training. Therefore, ChatGPT responses present a combination of accurate information, but also incomplete, ambiguous and, occasionally, misleading details. Purpouse ChatGenerative Chat Generative PreTrained Pre Trained ChatGPT. . (ChatGPT) misinformation Furthermore decisionmaking decision making pathway Therefore diagnoses Methods 35 3 5 3. used pMU, , (pMU) VUR. VUR (VUR) topic twice ChatGPTs s Afterwards combined Finally specialists performed Conclusion topics correct misinterpretation appropriate ureter suggested mentioned ineffective training incomplete occasionally details (ChatGPT (pMU (VUR

Abstract From a legal standpoint, naturalization is a secondary means of obtaining nationality in a state, resulting from the expression of will. Is it possible to regard the issue of naturalization solely as a legal matter and as an expression of individual will? This article seeks to address this question by engaging with the contributions of Abdelmalek Sayad, developing two arguments: (1) according to Sayad, naturalization should not be seen as a mere administrative operation that transforms, for example, an Algerian into a French citizen through a publication in the official gazette. Sayad believes that naturalization involves much more than just its legal dimension; (2) the issue of naturalization in Sayad's perspective should be understood within his critique of the post-colonial world, predominantly organized into nation-states. It is a world where international migrants are among those who experience and reveal the paradoxes, contradictions, inconsistencies of the contemporary world. standpoint state will arguments 1 (1 transforms example gazette dimension 2 (2 Sayads s postcolonial post colonial nationstates. nationstates nation states. states nation-states paradoxes contradictions (

Resumo Do ponto de vista jurídico, a naturalização é um modo secundário de se obter a nacionalidade de um Estado, resultante da manifestação de vontade. Mas é possível tratar a questão da naturalização apenas como uma questão jurídica e como uma manifestação de vontade individual? Este artigo procura responder esta indagação dialogando com as contribuições de Abdelmalek Sayad, desenvolvendo dois argumentos: (1) para Sayad a naturalização não deve ser encarada como uma simples operação administrativa, que como num ato de magia transforma, por exemplo, um argelino em um francês, através duma publicação no diário oficial. Para Sayad a naturalização envolve muito mais do que apenas sua dimensão jurídica; (2) a questão da naturalização em Sayad deve ser compreendida dentro de sua crítica ao mundo pós-colonial, hegemonicamente organizado em Estados-nação. Mundo onde migrantes internacionais estão entre aqueles que, por excelência, vivenciam e revelam os paradoxos - as contradições, incoerências do mundo contemporâneo. jurídico Estado individual argumentos 1 (1 administrativa transforma exemplo francês oficial 2 (2 póscolonial, póscolonial pós colonial, colonial pós-colonial Estadosnação. Estadosnação Estados nação. nação Estados-nação excelência contradições contemporâneo (

Abstract Phenoselenazines are nitrogen and selenium-based heterocyclic compounds that have important biological activities. However, their preparation methods are scarce and difficult to handle. The synthesis of a phenoselenazine from a simple and robust CuO nanoparticle catalyzed methodology, using bis-aniline-diselenide and 1,2-dihalobenzenes under microwave irradiation. Also, the double-cross-coupling reaction mechanism for C-Se and C-N bond formation, including the observation of a reaction intermediate by mass spectrometry have been studied. seleniumbased selenium based activities However handle methodology bisanilinediselenide bis aniline diselenide 1,2dihalobenzenes 12dihalobenzenes dihalobenzenes 1,2 1 2 irradiation Also doublecrosscoupling double cross coupling CSe C Se CN N formation studied 2dihalobenzenes 12 1,

Mangroves are highly productive ecosystems that support a diverse range of plant, animal, and microorganism species, especially fungi. This ecosystem is characterized as a transition zone between sea and land which is interesting because this environment can be considered an extreme environment due to the peculiar characteristics that it can exhibit, which is interesting for the establishment of diverse fungal species with great biotechnological potential, these habitats are relevant for the bioprospecting of interesting secondary-metabolite-producing fungi. Fungi play an essential role in maintaining this environment and also represent a rich source of structurally diverse antimicrobial compounds. This review summarizes antibacterial, antifungal, and antiviral chemicals produced by soil/sediment-derived mangrove fungi from 1990 to 2022. plant animal exhibit potential secondarymetaboliteproducing secondary metabolite producing compounds antibacterial antifungal soil/sedimentderived soilsedimentderived soil/sediment derived soil sediment 199 2022 sedimentderived soilsediment 19 202 1 20 2

Resumo Objetivo Avaliar a possível relação entre estado clínico na apresentação e distância percorrida a partir do distrito de saúde em mulheres com doença trofoblástica gestacional. Métodos Estudo transversal incluindo mulheres com doença trofoblástica gestacional dos 17 distritos de saúde do estado de São Paulo (I–XVII), Brasil, encaminhadas ao Centro de Doenças Trofoblásticas de Botucatu (distrito VI), entre 1990 e 2018. Na admissão, avaliaram-se mola hidatiforme pelo sistema de pontuação de risco de Berkowitz et al. e neoplasia trofoblástica gestacional pelo escore de risco/estadiamento Federação Internacional de Ginecologia e Obstetrícia / Organização Mundial da Saúde (FIGO/OMS). Coletaram-se dados demográficos, clínicos e distância percorrida e análises de regressão múltipla foram realizadas. Resultados Este estudo incluiu 366 mulheres (335 mola hidatiforme, 31 neoplasia trofoblástica gestacional). O estado clínico na apresentação e distância percorrida diferiram significativamente entre o centro especializado e demais distritos. Nas pacientes encaminhadas pelos distritos IX (β = 2,38 [0,87–3,88], p = 0,002) e XVI (β = 0,78 [0,02–1,55], p = 0,045), os escores de mola hidatiforme foram maiores que no centro especializado. As pacientes com neoplasia trofoblástica gestacional do distrito XVI apresentaram escores FIGO 3,32 vezes maior que no centro especializado (β = 3,32, 95% CI = 0,78–5,87, p = 0,010). A distância percorrida pelas pacientes dos distritos IX (200km) e XVI (203,5km) foi significativamente maior do que a percorrida pelas pacientes do centro especializado (76km). Conclusão Pacientes de distritos de saúde fora da cobertura do centro especializado apresentaram escores de risco mais alto para mola hidatiforme e para neoplasia trofoblástica gestacional na admissão. Longas distâncias (>80 km) pareceram influenciar negativamente o estado clínico da doença trofoblástica gestacional na apresentação, indicando barreiras no acesso a centros especializados. 1 I–XVII, IXVII I–XVII , I XVII (I–XVII) Brasil VI, VI VI) 199 2018 admissão avaliaramse avaliaram se al riscoestadiamento estadiamento FIGO/OMS. FIGOOMS FIGO/OMS . OMS (FIGO/OMS) Coletaramse Coletaram demográficos realizadas 36 335 (33 3 gestacional) β 238 2 38 2,3 0,87–3,88, 087388 0,87–3,88 0 87 88 [0,87–3,88] 0,002 0002 002 078 78 0,7 0,02–1,55, 002155 0,02–1,55 02 55 [0,02–1,55] 0,045, 0045 0,045 045 0,045) 332 32 3,3 95 078587 5 0,78–5,87 0,010. 0010 0,010 010 0,010) 200km km (200km 203,5km 2035km 203 5km (203,5km 76km. 76km (76km) >80 80 (>8 especializados (I–XVII 19 201 (FIGO/OMS 33 (3 23 2, 08738 0,87–3,8 8 [0,87–3,88 0,00 000 00 07 7 0, 00215 0,02–1,5 [0,02–1,55 004 0,04 04 3, 9 07858 0,78–5,8 001 0,01 01 20 (76km >8 (> ( 0873 0,87–3, [0,87–3,8 0,0 0021 0,02–1, [0,02–1,5 0785 0,78–5, > 087 0,87–3 [0,87–3, 0,02–1 [0,02–1, 0,78–5 08 0,87– [0,87–3 0,02– [0,02–1 0,78– 0,87 [0,87– 0,02 [0,02– 0,8 [0,87 [0,02 [0,8 [0,0 [0, [0 [

Abstract Objective To assess the potential relationship of clinical status upon admission and distance traveled from geographical health district in women with gestational trophoblastic disease (GTD). Methods This is a cross-sectional study including women with GTD from the 17 health districts from the São Paulo state (I–XVII), Brazil, referred to the Botucatu Trophoblastic Disease Center (specialized center, district VI), between 1990 and 2018. At admission, hydatidiform mole was assessed according to the risk score system of Berkowitz et al. Gestational trophoblastic neoplasia was evaluated using the International Federation of Gynecology and Obstetrics / World Health Organization (FIGO/WHO) staging/risk score. Data on demographics, clinical status and distance traveled were collected. Multiple regression analyses were performed. Results This study included 366 women (335 hydatidiform mole, 31 gestational trophoblastic neoplasia). The clinical status at admission and distance traveled significantly differed between the specialized center district and other districts. Patients referred from health districts IX (β = 2.38 [0.87–3.88], p = 0.002) and XVI (β = 0.78 [0.02–1.55], p = 0.045) had higher hydatidiform mole scores than those from the specialized center district. Gestational trophoblastic neoplasia patients from district XVI showed a 3.32 increase in FIGO risk scores compared with those from the specialized center area (β = 3.32, 95% CI = 0.78–5.87, p = 0.010). Distance traveled by patients from districts IX (200km) and XVI (203.5km) was significantly longer than that traveled by patients from the specialized center district (76km). Conclusion Patients from health districts outside the specialized center area had higher risk scores for both hydatidiform mole and gestational trophoblastic neoplasia at admission. Long distances (>80 km) seemed to adversely influence gestational trophoblastic disease clinical status at admission, indicating barriers to accessing specialized centers. GTD. . (GTD) crosssectional cross sectional 1 I–XVII, IXVII I–XVII , I XVII (I–XVII) Brazil VI, VI VI) 199 2018 al FIGO/WHO FIGOWHO WHO (FIGO/WHO stagingrisk staging demographics collected performed 36 335 (33 3 neoplasia. neoplasia) β 238 2 38 2.3 0.87–3.88, 087388 0.87–3.88 0 87 88 [0.87–3.88] 0.002 0002 002 078 78 0.7 0.02–1.55, 002155 0.02–1.55 02 55 [0.02–1.55] 0.045 0045 045 332 32 3.3 95 078587 5 0.78–5.87 0.010. 0010 0.010 010 0.010) 200km km (200km 203.5km 2035km 203 5km (203.5km 76km. 76km (76km) >80 80 (>8 centers (GTD (I–XVII 19 201 33 (3 23 2. 08738 0.87–3.8 8 [0.87–3.88 0.00 000 00 07 7 0. 00215 0.02–1.5 [0.02–1.55 0.04 004 04 3. 9 07858 0.78–5.8 001 0.01 01 20 (76km >8 (> ( 0873 0.87–3. [0.87–3.8 0.0 0021 0.02–1. [0.02–1.5 0785 0.78–5. > 087 0.87–3 [0.87–3. 0.02–1 [0.02–1. 0.78–5 08 0.87– [0.87–3 0.02– [0.02–1 0.78– 0.87 [0.87– 0.02 [0.02– 0.8 [0.87 [0.02 [0.8 [0.0 [0. [0 [

Abstract Objective To evaluate the efficacy of immunotherapy for GTN treatment after methotrexate-resistance or in cases of multiresistant disease, through a systematic review, as well as to present the first 4 Brazilian cases of immunotherapy for GTN treatment. Methods Three independent researchers searched five electronic databases (EMBASE, LILACS, Medline, CENTRAL and Web of Science), for relevant articles up to February/2023 (PROSPERO CRD42023401453). The quality assessment was performed using the Newcastle Ottawa scale for case series and case reports. The primary outcome of this study was the occurrence of complete remission. The presentation of the case reports was approved by the Institutional Review Board. Results Of the 4 cases presented, the first was a low-risk GTN with methotrexate resistance unsuccessfully treated with avelumab, which achieved remission with sequential multiagent chemotherapy. The remaining 3 cases were high-risk multiagent-resistant GTN that were successfully treated with pembrolizumab, among which there were two subsequent gestations, one of them with normal pregnancy and healthy conceptus. Regarding the systematic review, 12 studies were included, only one of them on avelumab, showing a 46.7% complete remission rate. The remaining 11 studies were on pembrolizumab, showing an 86.7% complete remission rate, regardless of tumor histology. Both immunotherapies showed good tolerability, with two healthy pregnancies being recorded: one after avelumb and another after pembrolizumab. Conclusion Immunotherapy showed effectiveness for GTN treatment and may be especially useful in cases of high-risk disease, where pembrolizumab achieves a high therapeutic response, regardless of the histological type, and despite prior chemoresistance to multiple lines of treatment. methotrexateresistance disease review EMBASE, EMBASE (EMBASE LILACS Medline Science, Science , Science) February2023 February 2023 February/202 PROSPERO CRD42023401453. CRD42023401453 CRD . CRD42023401453) Board presented lowrisk low risk avelumab chemotherapy highrisk multiagentresistant resistant gestations conceptus 1 included 467 46 7 46.7 rate 867 86 86.7 histology tolerability recorded response type February202 202 February/20 CRD4202340145 46. 8 86. February20 20 February/2 CRD420234014 February2 2 February/ CRD42023401 CRD4202340 CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4

Resumo Objetivo Avaliar aspectos emocionais e clínicos observados em mulheres com doença trofoblástica gestacional (DTG) acompanhadas em um centro de referência (CR), por equipe multiprofissional. Método Estudo de coorte retrospectivo nos prontuários clínicos de 186 mulheres comDTG, e dos aspectos emocionais (AE) observados nessas mulheres pela equipe de psicólogas e registrados nos 389 grupos de apoio (GAs), ocorridos de 2014 a 2018. Resultados As pacientes eram jovens (idade média 31,2 anos), 47% sem filhos vivos, 60% tinham desejado ou planejado esta gravidez e 50% delas participaram de dois ou mais GAs. A maioria (n=137-73,6%) apresentou remissão espontânea da gestação molar com mediana de 10 semanas e um tempo total de seguimento de 7 meses. Quarenta e nove mulheres (26,3%) evoluíram para neoplasia trofoblástica gestacional (NTG); amediana para atingir a remissão após tratamento comquimioterapia foi de 19 semanas e o tempo total de seguimento foi de 36 meses. Os AE incluíram variados graus de ansiedade e depressão, mais evidentes em 9,1% das nossas pacientes; tais AE tenderam a ocorrer mais em mulheres com idade acima de 40 anos (p=0,067), com menor escolaridade (p=0,054), com evolução para NTG (p=0,018), e nas que necessitaram de tratamento quimioterápico com regime de múltiplos agentes (p=0,028), ou de histerectomia complementar ao tratamento clínico (p=0,001). Conclusão Este estudo mostrou presença de vários AE associados em todos os tipos de DTG. Destaca tambéma importância de umatendimento psicológico especializado, somente encontrado nos CR, que é essencial para ajudar na recuperação da saúde mental dessas mulheres.

Abstract Objective To evaluate the emotional and clinical aspects observed in women with gestational trophoblastic disease (GTD) followed-up in a reference center (RC) by a multidisciplinary team. Methods Retrospective cohort study of the clinical records of 186 women with GTD and of the emotional aspects (EA) observed in these women by a teamof psychologists and reported by the 389 support groups conducted from 2014 to 2018. Results The women were young (mean age: 31.2 years), 47% had no living child, 60% had planned the pregnancy, and 50% participated in two or more SG. Most women (n=137; 73.6%) reached spontaneous remission ofmolar gestation in a median time of 10 weeks and had a total follow-up time of seven months. In the group of 49 women (26.3%) who progressed to gestational trophoblastic neoplasia (GTN), time to remission after chemotherapy was 18 weeks, and total follow-up time was 36 months. EA included different levels of anxiety and depression,more evident in 9.1% of the women; these symptoms tended to occur more frequently in women older than 40 years (p=0.067), less educated (p=0.054), and whose disease progressed to GTN (p=0.018), as well as in those who had to undergo multi-agent chemotherapy (p=0.028) or hysterectomy (p=0.001) adjuvant to clinical treatment. Conclusion This study found several EA in association with all types of GTD. It also highlights the importance of specialized care only found in a RC, essential to support the recovery of the mental health of these women.

Resumo Mola hidatiforme completa (MHC) é um tipo raro de gravidez, na qual 15 a 20% dos casos podem desenvolver neoplasia trofoblástica gestacional (NTG). O diagnóstico de NTG deve ser feito o mais cedo possível, pelo monitoramento semanal do hCG sérico após esvaziamento uterino. Relatamos o caso de uma paciente primigesta, de 23 anos de idade, com MHC, sem vigilância de hCG após esvaziamento uterino. Dois meses depois, a paciente compareceu na emergência com sangramento vaginal, sendo encaminhada ao Centro de Doenças Trofoblásticas do Hospital São Paulo, onde foi diagnosticada com NTG de alto risco, estádio e score de risco III:7 de acordo com a The International Federation of Gynecology and Obstetrics/Organização Mundial de Saúde (FIGO/OMS). O exame ultrassonográfico revelou útero aumentado com uma massa heterogênea constituída pormúltiplos vasos volumosos invadindo e desestruturando o miométrio. A paciente evoluiu com piora progressiva do sangramento vaginal após quimioterapia com o regime etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO). Ela foi submetida a transfusão de sangue e embolização das artérias uterinas devido aos episódios graves de hemorragia vaginal, com completo controle do sangramento. O hCG atingiu valor negativo após o terceiro ciclo, havendo regressão completa da vascularização uterina anômala, assim como recuperação da anatomia uterina. O tratamento em um centro de referência permitiu o manejo adequado, principalmente no que se refere à embolização das artérias uterinas através da punção percutânea da artéria femoral, que foi crucial para evitar a histerectomia, permitindo a cura da NTG e a manutenção da vida reprodutiva.

Abstract Complete hydatidiform mole (CHM) is a rare type of pregnancy, in which 15 to 20% of the cases may develop into gestational trophoblastic neoplasia (GTN). The diagnostic of GTN must be done as early as possible through weekly surveillance of serum hCG after uterine evacuation.We report the case of 23-year-old primigravida, with CHM but without surveillance of hCG after uterine evacuation. Two months later, the patient presented to the emergency with vaginal bleeding and was referred to the Centro de Doenças Trofoblásticas do Hospital São Paulo. She was diagnosed with high risk GTN stage/score III:7 as per The International Federation of Gynecology and Obstetrics/World Health Organization (FIGO/WHO). The sonographic examination revealed enlarged uterus with a heterogeneous mass constituted of multiple large vessels invading and causing disarrangement of the myometrium. The patient evolved with progressive worsening of vaginal bleeding after chemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) regimen. She underwent blood transfusion and embolization of uterine arteries due to severe vaginal hemorrhage episodes, with complete control of bleeding. The hCG reached a negative value after the third cycle, and there was a complete regression of the anomalous vascularization of the uterus as well as full recovery of the uterine anatomy. The treatment in a reference center was essential for the appropriate management, especially regarding the uterine arteries embolization trough percutaneous femoral

Resumo Objetivo Comparar o efeito de alta dose de vitamina A (VitA) no seguimento pósmolar de pacientes com gonadotrofina coriônica humana (hCG) sérica apresentando valoresbaixoseem platô(L&P). Métodos Estudo retrospectivo de série de casos comparando duas coortes não simultâneas. Grupo controle (CG): 34 pacientes com títulos de hCG sérico L&P submetidos a manejo expectante por 6 meses após o esvaziamento uterino, de 1992 a 2010; Grupo de Estudo (SG): de 2011 a 2017, 32 pacientes em condições semelhantes de hCG receberam Vit-A na dose de 200.000 IU por dia, do momento da identificação dohCG em platôate o primeirohCG normaloudiagnóstico de progressão para neoplasia trofoblástica gestacional (NTG). O presente estudo foi aprovado pelo Comitê de Ética da Instituição na qual foi desenvolvido. Resultados Em ambososgrupos, aprevalência de hCGL&P foi < 5%. No SG, os níveis de hCGemplatô forammaiores (CG = 85.5 versus SG = 195 IU/L; p = 0,028), e foram significantemente menores tanto a prevalência de NTG pós-molar (CG = 29.4% versus SG = 6.3%, p = 0,034) como o tempo de seguimento (CG = 14 versus SG = 10 meses, p < 0.001). Na evolução para NTG não houve diferença no estadiamento da Interna tional Federation of Gynecology and Obstetrics (FIGO, na sigla em inglês) ou na agressividade do tratamento. Com altas doses de Vit-A não houve qualquer efeito tóxico relevante. Não houve casos de recidiva de NTG ou de óbito. Conclusão O uso limitado de altas doses de Vit-A parace ser seguro e apresenta efeitos significativos na evolução de pacientes em controle pós-molar com títulos de hCG sérico L&P, e pode diminuir o desenvolvimento de NTG pós-molar nessa população.

Abstract Objective To compare the effect of high-dose vitamin A (HD Vit-A) use during postmolar follow-up of patients with low and plateauing (L&P) serum human chorionic gonadotropin (hCG) levels, from the moment serum hCG plateaued (P-hCG) to the first normal serum hCG value (< 5IU/L). Methods The present retrospective series case study compared two nonconcurrent cohorts of patients. Control group (CG): 34 patients with L&P serum hCG levels who underwent expectant management for 6 months after uterine evacuation, from 1992 to 2010; study group (SG): 32 patients in similar conditions who received 200,000 IU of Vit-A daily, from the identification of a P-hCG level to the first normal hCG value or the diagnosis of progression to gestational trophoblastic neoplasia (GTN), from 2011 to 2017. The present study was approved by the Ethics Committee of the institution where it was conducted. Results In both groups, the prevalence of persistent L&P serum hCG levels was < 5%. In the SG, hCG levels at plateau were higher (CG = 85.5 versus SG = 195 IU/L; p = 0.028), the rate of postmolar GTN was lower (CG = 29.4% versus SG = 6.3%, p = 0.034) and follow-up was shorter (CG = 14 versus SG = 10 months, p < 0.001). During GTN follow-up, there were no differences in GTN staging or treatment aggressiveness in both groups. High-dose Vit-A use did not have any relevant toxic effect. There were no GTN relapses or deaths. Conclusion The limited use of HD Vit-A seems to have a safe and significant effect on the treatment of postmolar patients with L&P serum hCG levels and may decrease the development of postmolar GTN in this population.

Resumo Esse relato apresenta um caso de neoplasia trofoblástica gestacional após mola hidatiforme parcial ocorrida na tuba uterina. Trata-se de uma associação rara, cuja incidência estima-se de 1 em cada 20.000 a 100.000 gestações, havendomenos de 300 casos apresentados na literatura ocidental. O tema é importante porque apresenta critérios diagnósticos atuais para essa ocorrência incomum, que vinha sendo diagnosticada equivocadamente, não apenas sob o ponto de vista morfológico, como também imunohistoquímico. Da mesma forma, alerta o obstetra para a ocorrência da gravidez molar ectópica, que tende a evoluir com rotura tubária mais frequentemente do que os casos de gravidez ectópica não molar. Por fim, a evolução do caso para neoplasia trofoblástica gestacional impõe às pacientes com gravidez ectópica molar a necessidade de seguimento pós-molar tão rigoroso quanto nos casos de mola hidatiforme intrauterina, ainda que o tratamento quimioterápico determine elevadas taxas de cura.

Abstract This report presents the case of a patient with gestational trophoblastic neoplasia after a partial hydatidiform mole formed in the Fallopian tube. Ectopic molar pregnancy is a rare condition, with an estimated incidence of 1 in every 20,000 to 100,000 pregnancies; less than 300 cases of it have been reported in the Western literature. The present report is important because it presents current diagnostic criteria for this rare condition, which has been incorrectly diagnosed in the past, not only morphologically but also immunohistochemically. It also draws the attention of obstetricians to the occurrence of ectopic molar pregnancy, which tends to progress to Fallopian tube rupture more often than in cases of ectopic non-molar pregnancy. Progression to gestational trophoblastic neoplasia ensures that patients with ectopic molar pregnancy must undergo postmolar monitoring, which must be just as thorough as that of patients with intrauterine hydatidiform moles, even if chemotherapy results in high cure rates.