scholarly journals Multiple metastatic gestational trophoblastic disease after a twin pregnancy with complete hydatidiform mole and coexisting fetus, following assisted reproductive technology: Case report and literature review

2018 ◽  
Vol 57 (4) ◽  
pp. 588-593 ◽  
Author(s):  
Ichiro Nobuhara ◽  
Naoya Harada ◽  
Noriko Haruta ◽  
Yumi Higashiura ◽  
Hideki Watanabe ◽  
...  
Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1038-1042
Author(s):  
Yan Wan ◽  
Guoqing Jiang ◽  
Ying Jin ◽  
Zengping Hao

Abstract Gestational trophoblastic disease (GTD) commonly occurs in reproductive females, but is extremely rare in perimenopausal females. In this study, we reported a case of hydatidiform mole in a 48-year-old perimenopausal female admitted due to a giant uterine mass of 28 weeks’ gestational size. The serum human chorionic gonadotropin (HCG) level ranged from 944 to 1,286 mIU/mL before treatments. The signs of preeclampsia and hyperthyroidism were relatively prominent. Hysterectomy was performed and chemotherapy was scheduled when the serum HCG level remained at a plateau, about 528 mIU/mL. The symptoms of preeclampsia and hyperthyroidism were relieved after treatment. Accordingly, we concluded that GTD could occur in perimenopausal woman and hysterectomy usually is the optimal treatment.


2020 ◽  
Vol 8 (12) ◽  
pp. 1096-1099
Author(s):  
Fouzia El Hilali ◽  
◽  
Salahedine Achkif ◽  
Sanaa Erraghay ◽  
Mohamed Karam Saoud ◽  
...  

Twin pregnancy involving a complete mole and a normal singleton pregnancy with its own healthy trophoblast is a rare entity. The most serious complication is the progression to gestational trophoblastic disease. Reporting the case of a 38-year-old pastry, G5P4, consultant for bleeding after pregnancy of 16 weeks not followed, whose pelvic ultrasound showed the appearance of an association of a complete hydatidiform mole and a normal singleton pregnancy .The patient had a spontaneous abortion 48 hours after her hospitalization. The anathomopathologic study confirmed the diagnosis of the association of a complete mole and a normal placenta. The evolution is marked by the non-evolution towards gestational trophoblastic disease. 


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Anuradha Jayasuriya ◽  
Dimuthu Muthukuda ◽  
Preethi Dissanayake ◽  
Shyama Subasinghe

Background. Gestational trophoblastic disease (GTD) which includes hydatidiform mole, invasive mole, placental site trophoblastic tumor, and choriocarcinoma is a rare cause of hyperthyroidism due to excess production of placental human chorionic gonadotrophin hormone (hCG) by tumor cells. Molecular mimicry between hCG and thyroid stimulating hormone (TSH) leads to continuous stimulation of TSH receptor by extremely high levels of hCG seen in these tumors. Consequently, biochemical and clinical hyperthyroidism ensues and it is potentially complicated by thyrotoxic crisis which is fatal unless urgent therapeutic steps are undertaken. Case Description. We present a 49-year-old perimenopausal woman who presented with recurrent thyroid storm and high output cardiac failure. The initial workup revealed suppressed TSH, high-free thyroxine (FT4), and free triiodothyronine (FT3) levels with increased vascularity of the normal-sized thyroid on ultrasonography. She was managed with parenteral beta blockers, steroids, and high-dose carbimazole. Her lower abdominal tenderness led to further investigations which revealed tremendously elevated beta-hCG and a snow storm appearance on transabdominal ultrasound suggestive of GTD. She underwent curative surgery and was diagnosed with complete hydatidiform mole postoperatively by histology. Conclusion. Recurrent thyroid crisis in gestational trophoblastic disease is an exceedingly rare presentation and that is highly fatal. This case highlights the importance of early detection and treatment of the etiology of thyrotoxicosis to eliminate mortality.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Abba Kabir ◽  
Abdulkarim A. Kullima ◽  
Adamu I. Adamu ◽  
Anna Peter ◽  
Abba Z. Bukar ◽  
...  

A twin pregnancy comprising a complete hydatidiform mole coexisting with a foetus is a rare obstetric condition with an incidence of 1 in 22,000 to 1 in 100,000 pregnancies. The management of such case is challenging due to the associated risk of maternal and foetal complications. We report a case of a 25-year-old woman, gravida 2, para 1 with a normal intrauterine pregnancy coexisting with complete hydatidiform mole. An ultrasound scan demonstrated normal foetus and placenta along with coexistent intrauterine echogenic mass with features of hydatidiform mole. The microscopic examination of the abnormal placenta confirmed complete hydatidiform mole. Although twin pregnancy with complete hydatidiform mole and coexistent foetus is associated with increased risk of developing maternal and foetal complications, continuation of pregnancy may be an acceptable option under close monitoring to detect early signs of complications.


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