scholarly journals Twin pregnancy with complete hydatiform mole and coexisting live fetus: A rare case report

2019 ◽  
pp. 31-34
Author(s):  
Swati Agrawal ◽  
Kiran Aggarwal ◽  
Anjali Singh ◽  
Khushbu Saha ◽  
Amrita Mishra ◽  
...  

Twin pregnancy with one live fetus and one complete mole, also known as CMCF i.e. complete molar pregnancy with coexisting live fetus is a rare entity in obstetrics. This combination is associated with increased incidences of spontaneous abortions, vaginal bleeding, prematurity, intrauterine demise, pre-eclampsia, uterine ruptures, theca lutein cysts, persistent gestational trophoblastic disease. We report a rare case of a 24-year-old patient with CMCF at 14 weeks of gestation. After confirming the diagnosis, ruling out malignancy and proper counselling, decision was taken to continue her pregnancy. However, the patient had spontaneous abortion at 15 weeks of gestation. Her serum beta Hcg has shown a decreasing trend in her follow up visits with no signs suggestive of persistent gestational trophoblastic disease.

Author(s):  
Muskaan Chhabra ◽  
Rekha Daver

Gestational trophoblastic disease or gestational trophoblastic neoplasia is a collective term used to describe hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumours. Since any molar pregnancy has the potential to develop into invasive mole these patients should be carefully monitored for development of malignant disease. Here we are reporting a case of invasive molar pregnancy with a single live fetus of 17 weeks gestational age. A 24 years old woman, G3P2L2 with a history of amenorrhea since approximately 5 months presented with profuse per vaginal bleeding. Ultrasound showed presence of live fetus of approximate gestational age of 17 weeks. Along with the fetus there was also presence of cystic areas with no vascularity s/o Hydatiform mole. In view of continued bleeding and severe anemia pregnancy was terminated and fetus along with vesicular tissue was expelled. On follow up Beta hcg titers showed increasing trend over the next week. Repeat USG showed extension of molar tissue into the myometrium. In view of this she was given 3 cycles of chemotherapy and eventually was discharged. She was followed up regularly with no e/o recurrence. Presence of viable fetus along with hydatiform mole is a rare occurrence in obstetric practice. After termination of pregnancy these patients should undergo follow up ultrasound and serial beta HCG titers to detect the malignant transformation. Rising beta HCG titers and invasion of myometrium on ultrasound are the ominous features suggesting malignant transformation and should be treated accordingly.


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. 


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fatemeh Davari Tanha ◽  
Saghar Samimi Sede ◽  
Fariba Yarandi ◽  
Elham Shirali ◽  
Maliheh Fakehi ◽  
...  

Abstract Background This study aimed to describe the efficacy of hysteroscopy in the management of women with the persistent gestational trophoblastic disease (PGTD)/GTN to reduce the need for chemotherapy. Materials and methods This prospective, single-arm, clinical trial study was recruited in an educational referral hospital between September 2018 and September 2019. Totally, 30 participants with a history of hydatidiform mole that was managed by uterine evacuation and developed low risk persistent gestational trophoblastic disease were recruited. Hysteroscopy was performed for removal of persisted trophoblastic tissue. Serum beta-hCG titer was measured before and 7 days after the procedure. Results The mean ± SD age of the participants was 31.4 ± 4.6 years. There was a significant difference (p = 0.06) between that mean ± SD of beta-hCG titer before (8168.4 ± 1758) and after (2648.8 ± 5888) hysteroscopy. Only two (6.6%) cases underwent chemotherapy due to no drop in the beta-hCG titer. Conclusion Hysteroscopy may play a significant role in the management of GTN, although it requires validation in larger prospective randomized studies and longer follow-up.


Author(s):  
Nagashree U. ◽  
Wahida Suresh

Benign gestational trophoblastic disease (GTD) generally occurs in reproductive age group women; but is extremely rare in peri and post-menopausal women. We report a case of molar pregnancy in a 48-year-old lady with complaints of bleeding per vaginum with severe pain abdomen. The intention was to highlight the need to include GTD as a possible cause of abnormal bleeding per vaginum in peri and post-menopausal women. So early diagnosis and management with proper follow up is possible. It stresses the need for early recognition to avoid high malignant sequelae.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Parth Rali ◽  
Jianwu Xie ◽  
Grishma Rali ◽  
Mayur Rali ◽  
Jan Silverman ◽  
...  

Choriocarcinoma is part of the spectrum of gestational trophoblastic disease that occurs in women of reproductive age. Although the most common metastatic site of choriocarcinoma is the lung, primary pulmonary choriocarcinoma is rare. To diagnose primary pulmonary choriocarcinoma, the patient should have no previous gynecologic malignancy, have elevated human chorionic gonadotropin, and have pathological confirmation of the disease excluding gonadal primary site of the tumor. Due to the paucity of data, there are no guidelines for treatment. Prognosis of this malignancy is extremely poor. We report a rare case of metastatic primary lung choriocarcinoma in a 69-year-old postmenopausal woman who was treated with combination of surgery, chemotherapy, and radiation. The patient had a good outcome and is doing well after 1-year follow-up.


Author(s):  
Nisha Bhagat ◽  
Rajnish Raj

The gestational trophoblastic disease is a group of interrelated lesions that arise from abnormal proliferation of placental trophoblast. It comprises of hydatidiform mole (partial or complete), invasive mole, placental site trophoblastic tumor and choriocarcinoma. The occurrence of hydatidiform mole in more than two conceptions is known as recurrent hydatidiform mole. Although, its incidence is less than 2% but it may progress to invasive mole or choriocarcinoma. The case of 26-year old female is reported; she had five consecutive molar pregnancies and the sixth one developed into invasive mole with co-morbid depression that was managed by methotrexate chemotherapy, antidepressant and psychotherapy. 


2020 ◽  
Author(s):  
Fatemeh Davari Tanha ◽  
Saghar Samimi Sede ◽  
Fariba Yarandi ◽  
Elham Shirali ◽  
Malihe Fakehi ◽  
...  

Abstract Background: This study aimed to describe the efficacy of hysteroscopy in the management of women with persistent gestational trophoblastic disease to decrease the chemotherapy need.Materials and methods: This prospective, single-arm, clinical trial study was conducted at a tertiary educational referral hospital between September 2018 and September 2019. In the follow-up of the patients diagnosed with hydatidiform mole and managed by uterine evacuation, 30 cases developed low risk persistent gestational trophoblastic disease. Hysteroscopy was performed for removal of persisted trophoblastic tissue, before chemotherapy. Serum beta-hCG titer was measured before and 7 days after the procedure.Results: Mean±SD age of the participants was 31.4±4.6 years. There was a significantly difference (p=0.06) between that mean±SD of beta-hCG titer before (8168.4±1758) and after (2648.8±5888) treatment. Two (6.6%) cases needed chemotherapy due to no decrease in beta-hCG titer. Conclusion: Although, hysteroscopy may play a significant role in the management of persistent gestational trophoblastic disease but requires validation in larger prospective randomized studies and longer follow-up.


Author(s):  
Markandeya Tiwari ◽  
Vinson Louis Gonzaga Fernandes ◽  
Nina Margarida De Gouveia Pinto ◽  
Isha Rajendra Sukhthankar

<p class="abstract">Verrucous carcinoma is a rare well differentiated squamous cell carcinoma with minimal metastatic potential. Its occurrence in the glottic and subglottic subsets of the larynx is another very rare entity. We highlight a case of an elderly male who was histopathologically diagnosed as verrucous carcinoma of the glottic and subglottic larynx. We shall discuss the clinical presentation, diagnosis, management, prognosis and postoperative follow up of the patient.</p><p class="abstract"> </p>


2013 ◽  
Vol 20 (04) ◽  
pp. 638-641
Author(s):  
SHAMA CHAUDHARY ◽  
IQRA JANGDA ◽  
RUBINA HUSSAIN

Ectopic molar pregnancy is a rare occurrence. Clinical diagnosis of a molar pregnancy is difficult but histopathology is thegold standard for diagnosis. The management of ectopic molar pregnancies consists of surgically removing the conceptus, follow up &chemotherapy, if required. We are reporting a case report of a 35-year-old married, nulliparous woman, admitted in emergency with a 6-week history of amenorrhea, severe abdominal pain & an episode of fainting at home. Per abdominal examination revealed tendernessover the right iliac fossa, with guarding & rigidity. Diagnosis of ruptured ectopic pregnancy was made.Emergency laparotomy was done.Histopathological examination, showed tubal ectopic pregnancy with partial hydatidiform mole & a separate corpus luteal cyst.She wasfollowed up with serial beta hCG which became normal within 1 month. Although ectopic molar pregnancy is a rare entity but all ectopicpregnancies should be examined histologically to rule out presence of gestational trophoblastic disease to plan follow-up accordingly inorder to avoid persistent gestational trophoblastic disease which has a chance of malignant conversion.The prognosis of ectopic molarpregnancies is the same as for other forms of gestational trophoblastic disease.


Author(s):  
Bibechan Thapa ◽  
Meenu Maharjan ◽  
Heera Tuladhar

Ovarian molar pregnancy, though a very rare entity, behaves like any other molar pregnancy. After surgical management, close follow-up with Beta Human Chorionic Gonadotrophin surveillance is invariable to detect progression to persistent Gestational Trophoblastic Disease, which if develops can be treated successfully with chemotherapy.


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