Invasive Hydatidiform Mole: A Rare Complication of Gestational Trophoblastic Disease. Case Report
Main Article Content
Abstract
Background: Gestational trophoblastic disease (GTD) comprises a heterogeneous group of disorders arising from abnormal proliferation of trophoblastic tissue. Invasive hydatidiform mole is an uncommon but potentially serious complication, characterized by myometrial invasion and, rarely, metastatic spread. Early diagnosis is essential due to its high curability with appropriate management.
Case presentation: 34-year-old primigravida who presented with abdominal pain, amenorrhea, severe anemia, and markedly elevated β-human chorionic gonadotropin (β-hCG) levels. Pelvic ultrasound revealed a heterogeneous endometrial mass with cystic areas, and magnetic resonance imaging suggested invasive trophoblastic disease. Due to the risk of uterine complications, total abdominal hysterectomy was performed. Histopathological examination confirmed the diagnosis of invasive hydatidiform mole without evidence of extrauterine spread.
Conclusion: Invasive hydatidiform mole, although rare, should be suspected in patients with persistently elevated or rising β-hCG levels following molar pregnancy. Strict post-evacuation surveillance and a multidisciplinary approach are crucial to prevent delayed diagnosis and ensure favorable outcomes.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Berkowitz RS, Goldstein DP. Clinical practice. Mole pregnancy. N Engl J Med. 2009;360(16):1639–45.
II. Lurain JR. Gestational trophoblastic disease I. Am J Obstet Gynecol. 2010;203(6):531–9.
III. Sebire NJ, Fisher RA, Foskett M, et al. Reproductive outcomes after complete and partial mole pregnancy. Lancet. 2002;359(9324):224–8.
IV. Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376(9742):717–29.
V. Savage P, Seckl MJ. Gestational trophoblastic neoplasia. BMJ. 2010;340:c1110.
VI. Ngan HY, Seckl MJ, Berkowitz RS, et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet. 2018;143 Suppl 2:79–85.
VII. Goldstein DP, Berkowitz RS. Current management of gestational trophoblastic neoplasia. Hematol Oncol Clin North Am. 2012;26(1):111–31.
VIII. Lurain JR. Gestational trophoblastic disease II. Am J Obstet Gynecol. 2011;204(1):11–8.
IX. FIGO Oncology Committee. FIGO staging for gestational trophoblastic neoplasia. Int J Gynaecol Obstet. 2002;77(3):285–7.
X. Ngan HY, Bender H, Benedet JL, et al. Gestational trophoblastic neoplasia, FIGO 2000 staging and classification. Int J Gynaecol Obstet. 2003;83 Suppl 1:175–7.
XI. Braga A, Mora P, de Melo AC, et al. Challenges in the diagnosis and treatment of invasive mole. Best Practice Res Clin Obstet Gynaecol. 2021;74:35–46.
XII. Seckl MJ, Hancock BW, Berkowitz RS. Treatment of gestational trophoblastic disease. Lancet. 2010;376(9742):717–29.
XIII. Lurain JR. Chemotherapy for gestational trophoblastic disease. Best Practice Res Clin Obstet Gynaecol. 2003;17(6):943–59.
XIV. Berkowitz RS, Goldstein DP. Advances in the management of gestational trophoblastic disease. Clin Obstet Gynecol. 2003;46(3):541–56.
XV. F Migliorelli, R Pascal, N Baños, A Goncé, MD Gómez-Roig, M Palacio. Management of the mole hidatiforme. Clinic of Barcelona. 2023; 1-9
XVI. Baljeet Kaur FRCPath, Pathology of gestational trophoblastic disease (GTD). Best Practice & Research Clinical Obstetrics & Gynaecology, volume 74, July 2021, pages 3-28
XVII. Ourlad Alzeus G. Tantengco, Federico Cristobal C. De Jesus II et al. Mole pregnancy in the last 50 years: A bibliometric analysis of global research output. Placenta, Volume 112, September 1, 2021, pages 54-61.