A mother-of-three has warned that her rare womb cancer was mistaken for a pregnancy, despite her husband’s vasectomy months earlier.
In 2009, 23-year-old Courtney Snalium of Texas was waiting in the emergency room for a case of bronchitis when she passed out.
Despite the fact that her husband had just undergone a vasectomy the year before, the doctors insisted on ordering a pregnancy test as they said it was standard procedure at the hospital. Surprisingly, it came back positive.
However, Ms Snalium’s HCG (human chorionic gonadotropin) levels, which are produced by the placenta during pregnancy to thicken the uterine wall, were low for a pregnant woman – about 20 times lower than what they should have been.
While she and doctors were in confusion for months, the theology student eventually went for additional tests and was ultimately diagnosed with placental trophoblastic tumor (PSTT), a disease so rare that only 300 cases have ever been recorded in the medical literature.
Courtney Snalium was 23 when doctors mistook her ultra-rare cancer – placental trophoblastic tumor (PSTT) – for pregnancy
After her positive pregnancy test, doctors suggested that Ms Snalium, now 39, have additional blood tests done to ensure her HCG levels were rising normally, but she decided against this.
“I’d already had three flawless pregnancies and I thought this one would probably be fine too,” Ms Snalium said in a TikTok video.
However, an obstetrician/gynecologist urged her to have more tests and a week later Ms Snalium’s HCG was 12 – unchanged from her first test – despite the fact that this normally doubles every day during pregnancy.
‘The doctor says: ‘I asked my colleagues. None of us know what this could be, but one thing we are certain of is that you do not, in fact, have a viable pregnancy,” she said.
“We scheduled an ultrasound and nothing showed up on the ultrasound.”
Believing the pregnancy was not viable, doctors performed a dilation and curettage (D&C), a procedure in which tissue is removed from the uterus. It can be used for miscarriage or termination of pregnancy within the first trimester.
Three months after her positive pregnancy test, the results of her D&C led to Ms. Snalium ultimately being diagnosed with placental trophoblastic tumor (PSTT), which develops from remnant cells that attach the placenta to the uterine wall during pregnancy.
As the remaining cells form from the placenta, small amounts of the pregnancy hormone HCG are released, which resembles a positive pregnancy test.
Despite her positive pregnancy test, levels of the pregnancy hormone HCG failed to rise normally, Ms Snalium said. Her levels were 20 times lower than they should have been
Doctors were able to treat her cancer by performing a hysterectomy, which involves removing the uterus and often the cervix. About 15 years later, Mrs. Snalium is cancer-free
She said: ‘I had one of the rarest forms of female cancer there is.’
‘What makes these tumors so unique is that they do not respond to chemotherapy. Most cancers [are] rapidly dividing cells, and chemotherapy attacks rapidly dividing cells.
“But this one grows very slowly, so the prognosis depends entirely on when they catch it.”
If PSTT is caught before it spreads, it can be successfully cured with a hysterectomy, a surgery to remove a woman’s uterus and cervix.
However, if the cancer spreads — this form typically goes to the lungs — “the prognosis is very grim,” Ms. Snalium said.
Experts estimate that the cancer spreads in about 30 percent of cases and that tumors can be found between one and fourteen years after pregnancy.
The cancer can also spread to the liver, lymph nodes and brain.
There is no confirmed survival rate for the cancer because it is so rare, but doctors estimate it can range from 30 percent if the cancer has spread throughout the body to as high as 90 percent if the cancer has remained localized.
Doctors estimated that Ms Snalium’s tumor had been growing for about 18 months, and was likely to have spread within another six months.
“I had no symptoms,” she said. ‘A small breakthrough [vaginal bleeding]but nothing that would ever have caused concern.’
Typical symptoms of PSTT include abnormal vaginal bleeding or amenorrhea, the absence of menstruation.
‘It was a miraculous discovery that only happened because I had bronchitis so bad I fainted. It was completely unrelated,” Ms Snalium added.
Doctors performed a hysterectomy and regularly checked Ms. Snalium’s blood for rising HCG levels or other abnormalities.
Fifteen years later, she remains cancer-free, adding, “I like to tease my husband about how he got a vasectomy for nothing.”