scholarly journals Invasive Molar Pregnancy in a Woman Aged 55 Years: A Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 226-230
Author(s):  
M. Hristova ◽  
S. Bozhilov ◽  
N. Hristov ◽  
Y. Tancheva ◽  
N. Ivanova ◽  
...  
Keyword(s):  
Case Report ◽  
Complete Blood Count ◽  
Transvaginal Ultrasound ◽  
Abdominal Hysterectomy ◽  
Molar Pregnancy ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
Β Hcg ◽  
Invasive Mole ◽  
Prophylactic Chemotherapy

BACKGROUND: Gestational trophoblastic diseases (GTDs) are a group of rare human tumors by abnormal trophoblastic proliferation. GTD is neoplasia that develops from the trophoblastic element of blastocyst. In this case, some specific features of the trophoblast are retained, while the hCG (Human Chorionic Gonadotropin) synthesis and invasion potential of the underlying tissues are preserved. CASE REPORT: We reported a 55-year-old patient with invasive (destructive) mole hydatidiform “FIGO I” with invasion in myometrium wall. This diagnostic was suggested by abnormal (dysfunctional) vaginal bleeding, amenorrhea period, and low abdominal pain. Our paraclinical investigation was physical examination, transabdominal, and transvaginal ultrasound and complete blood count. Transabdominal and transvaginal ultrasound reveal enlarged uterus volume, with dimensions 18/12/5 cm and with Doppler rich blood supply through myometrium and endometrium. Therapeutic method applied was abdominal hysterectomy and bilateral salpingo-oophorectomy. Anatomopathological report revealed a complete invasive mole. After the surgical intervention, the patient was no treated with methotrexate as prophylactic chemotherapy (recommended by oncologists) because the level of β-hCG was very low. CONCLUSION: Examining the tissue after a miscarriage in women at extreme ages should raise a suspicion of mole. Molar pregnancy should be excluded in these cases.

scholarly journals A molar pregnancy detected by following irregular vaginal bleeding after a first trimester evacuation: rare case report

2019 ◽  
Vol 8 (6) ◽  
pp. 2549
Author(s):  
Meena Bhati Salvi
Keyword(s):  
Case Report ◽  
Vaginal Bleeding ◽  
Transvaginal Ultrasound ◽  
Correct Diagnosis ◽  
First Trimester ◽  
Molar Pregnancy ◽  
Sequence Of Events ◽  
Beta Hcg ◽  
Surgical Evacuation ◽  
Invasive Mole

In this case report summarizes the sequence of events that led to detection of a molar pregnancy missed by ultrasound and initial pathology examination. A 29 years old Asian nulliparous patient came to our clinic with missed period. On beta HCG she was 6 weeks pregnant. After 20 days she was diagnosed with 7 weeks missed abortion on ultrasound. surgical evacuation done for same. After 3 weeks she came with irregular vaginal bleeding. After physical and vaginal examination Beta HCG done, which was very high. On transvaginal ultrasound partial molar pregnancy was detected, so she was immediately admitted and repeat surgical evacuation was done. Histopathology report confirmed partial molar pregnancy which was not detected in previous report. She was regularly followed up with Beta HCG value up to 1 year which declined dramatically. Though molar pregnancy is rare, but it has the potential to develop into invasive mole, so any abnormal bleeding post evacuation should be followed up properly. Beta HCG values and histopathological evaluation is important for correct diagnosis and follow up.

Extrauterine Epithelioid Trophoblastic Tumor (ETT) Arising from an Antecedent Undiagnosed Molar Pregnancy Presenting as an Adnexal mass: A Case Report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S78-S78
Author(s):  
J Gallardo ◽  
K Hummel ◽  
K McCluskey ◽  
R Masand ◽  
J Sunde
Keyword(s):  
Case Report ◽  
Tumor Cells ◽  
Dna Fingerprinting ◽  
Adnexal Mass ◽  
Molar Pregnancy ◽  
Fingerprinting Analysis ◽  
Trophoblastic Tumor ◽  
Eosinophilic Cytoplasm ◽  
Epithelioid Trophoblastic Tumor ◽  
Β Hcg

Abstract Introduction/Objective Epithelioid trophoblastic tumor (ETT) is an extremely rare neoplasm derived from chorionic type intermediate trophoblast. ETT usually follows an antecedent term pregnancy but can also follow spontaneous abortions or molar pregnancy. ETT most often arises from the endometrium, followed by the cervix. Extrauterine ETT are extremely rare, with few cases reported in literature. Methods/Case Report A 41-year-old woman with three term pregnancies presented with abdominal pain, ten years after her last pregnancy. Imaging findings of a 3.5 cm adnexal mass coupled with an elevated serum β-hCG (~ 900 mIU/ml), led to the suspicion of an ectopic pregnancy. Hysterectomy with salpingectomy revealed a 4.7 cm, tan- yellow, necrotic mass in the adnexal region abutting but distinct from the uterine serosa. Histologic evaluation showed a well- circumscribed tumor with pushing borders. The tumor cells were epithelioid with well-defined eosinophilic cytoplasm, monomorphic nuclei, frequent mitosis, and abundant geographic necrosis. The tumor cells were positive for β-hCG, GATA-3, PLAP and inhibin, with focal weak staining squamous markers p63 and p40. DNA fingerprinting analysis, performed to confirm the diagnosis of ETT, revealed a homozygous tumor with two copies of non-maternal genes indicating that the antecedent index gestation giving rise to the tumor was an undiagnosed hydatidiform mole. Following surgery, serum β-hCG levels were normal and the patient is currently on surveillance. Results (if a Case Study enter NA) NA Conclusion We present an extremely rare case of extrauterine ETT arising from a previously undetected molar pregnancy. The diagnosis should be suspected when a mass is observed at extrauterine sites with elevated β-hCG levels in patients with or without vaginal bleeding. Histologic differential of squamous cell carcinoma needs to be ruled out with immunostains. Due to its rarity and highly variable presentation, this entity remains a diagnostic challenge. DNA fingerprinting analysis demonstrating non-maternal genes can help confirm the diagnosis of ETT.

scholarly journals A Rare Case Report of Molar Pregnancy with Coexisting Fetus

2018 ◽  
Vol 04 (01) ◽  
pp. 037-039
Author(s):  
Richa S Nathani ◽  
Zeba Nisar
Keyword(s):  
Case Report ◽  
Hydatidiform Mole ◽  
Rare Condition ◽  
Healthy Infant ◽  
Molar Pregnancy ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Optimal Outcomes ◽  
Rare Case Report ◽  
Β Hcg

Abstract Aim: Here we report a molar pregnancy with a coexisting fetus progressing to a viable, healthy infant which is an extreme rarity, with the incidence of 0.005–0.01% of all the pregnancies. Background: Partial mole is defined as excessive trophoblastic proliferation with normal and hydropic villi and presence of a fetus or a fetal circulation with nucleated cells. Partial molar pregnancy with a singleton live fetes is a rare condition. it is commonly seen with twin gestation and it is rare with singleton pregnancy Case report: A 30 years old primigravida, referred from a private hospital at 38 weeks of gestation delivered a phenotypically normal and healthy infant 2200 gm in weight by caesarean section. The placenta weighed 500 gms and on sectioning revealed widespread, grape-like vesicles. Light microscopy revealed normal villi coexisting with villi showing hydropic change and cistern formation and diffuse circumferential trophoblastic hyperplasia consistent with molar change. A diagnosis of partial molar pregnancy with normal fetus was made. Conclusion: Very few twin pregnancies with a hydatidiform mole and a foetus continue to term as they often have spontaneous or induced terminations for maternal complications Management of molar changes associated with normal appearing fetus still remains challenging as not many studies have been done due to rarity of this disorder. Clinical significance: Though the general trend is to terminate pregnancy in foetus with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Monitoring of serum β-hCG, serial ultrasound for fetal growth, size of molar component, and theca lutein cysts can help to predict good patient outcomes.

scholarly journals Gestational trophoblastic diseases: an observational study at a tertiary care teaching hospital in Jharkhand, India

2020 ◽  
Vol 9 (8) ◽  
pp. 3138
Author(s):  
Archana Kumari ◽  
Nikita Chauhan
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Molar Pregnancy ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Disease Spectrum ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases

Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.

scholarly journals Submucosal Uterine Fibroid in Grand Multipara Woman: A Case Report

2021 ◽  
Vol 9 (T3) ◽  
pp. 27-30
Author(s):  
Muhammad Rusda ◽  
Arvitamuriany Triyanthi Lubis ◽  
Muhammad Ramadhan Hisworo ◽  
Andrina Yunita Murni Rambe
Keyword(s):  
Case Report ◽  
Uterine Fibroid ◽  
Normal Limit ◽  
Transvaginal Ultrasound ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Normal Limits ◽  
Grand Multiparity ◽  
Chief Complaints ◽  
One Year

Background: to report and analyze a case that diagnosed with submocous uterine fibroid in grand multiparity woman. Methods: Case Report Case: a 49 years woman, P7A0 came with chief complaints vaginal bleeding that has been experienced since one year ago getting worse in 2 months. Her general condition was within normal limit and there was no abnormality in physical examination, by vaginal examination there was blood in the vagina, origin from the External Uterine Orificium (EUO),bimanual examination showed anteflexion uterus with normal size, right and left adnexa within normal limits. From transvaginal ultrasound we found submucous uterine fibroid size 3 x 3 cm, we decided to perform Total Abdominal Hysterectomy. Conclusion: Hysterectomy is a progressive and definitive uterine fibroid procedure. For women who do not want to conceive and/or women over 40-50 years of age, in particular.

scholarly journals Partial Hydatidiform Mole with Alive Term IUGR Foetus

2017 ◽  
Vol 34 (3) ◽  
pp. 164-167 ◽  
Author(s):  
Rowshan Ara ◽  
Jahanara Begum ◽  
Setara Binte Kasem ◽  
Shadiqul Hoque ◽  
Shamim Fatema Nargis
Keyword(s):  
Intrauterine Growth Retardation ◽  
Hydatidiform Mole ◽  
Stage Iv ◽  
Molar Pregnancy ◽  
Fetal Abnormality ◽  
Intrauterine Growth ◽  
Trophoblastic Diseases ◽  
Spontaneous Labour ◽  
Gestational Trophoblastic Diseases ◽  
Live Fetus

Gestational Trophoblastic diseases consist of a broadspectrum of conditions ranging from an uncomplicated partial hydatidiform molar pregnancy to stage -IV choriocarcinoma with cerebral metastasis. Incidence of hydatidiform mole with a co-existing live fetus varies between 0.005 to 0.01 % of all pregnancies. We report a case of partial molar pregnancy with alive term IUGR (intrauterine growth retardation) foetus. Diagnosis was made by sonographic findings of molar changes at her 28 weeks of gestation. Anomaly scan showed no fetal abnormality. At 40 weeks of pregnancy patient went to spontaneous labour and delivered a severely IUGR baby weighing 1.5 kg and it was morphologically normal. There was a single placenta; one third of it was replaced by molar tissue. As the singletone alive pregnancy with partial molar changes is extremely rare occurrence we reported the case here.J Bangladesh Coll Phys Surg 2016; 34(3): 164-167

scholarly journals Brain metastases of choriocarcinoma: A report on two cases

2013 ◽  
Vol 70 (10) ◽  
pp. 968-971 ◽  
Author(s):  
Vera Milenkovic ◽  
Biljana Lazovic ◽  
Ljiljana Mirkovic ◽  
Danica Grujicic ◽  
Radmila Sparic
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Combined Treatment ◽  
Biological Behavior ◽  
Successful Outcome ◽  
Gynecological Malignancy ◽  
Trophoblastic Diseases ◽  
Placental Site ◽  
Gestational Trophoblastic Diseases ◽  
Invasive Mole

Introduction. Gestational trophoblastic diseases (GTD) are a spectrum of tumors with a various of biological behavior and potential for metastases. It consists of hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor. Choriocarcinoma presents a very aggressive tumor with high malignant potential. Case report. We presented the two cases of choriocarcinoma with brain metastases. The first one was manifested by neurological deterioration as the first sign of metastasis, while the second patient had firstly metrorrhagia and in the further couse neurological disturbances that suggested the presence of brain tumor. In both cases we applied a combined treatment of surgery, chemotherapy and radiation therapy. Both patient survived with high quality of life. Conclusion. A successful outcome of brain metastases of choriocarcinoma was obtained by the use of a combined treatment of surgery, chemotherapy and radiation therapy. In cases of young women with brain metastases, gynecological malignancy should be always considered.

scholarly journals Partial molar pregnancy associated with a normal appearing foetus: a case report and review of the literature

2017 ◽  
Vol 6 (6) ◽  
pp. 2681
Author(s):  
Sujata Singh ◽  
Sasmita Swain ◽  
Lucy Das ◽  
Pravat Chandra Das
Keyword(s):  
Case Report ◽  
Trisomy 21 ◽  
Vaginal Bleeding ◽  
Hydatidiform Mole ◽  
Molar Pregnancy ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Cystic Changes ◽  
Β Hcg ◽  
Moderate Anaemia

Partial molar pregnancy is a rare entity in which there is usually a triploid abnormal foetus associated with a large placenta with cystic changes. The incidence of a normal diploid foetus and a partial molar placenta is extremely rare. Here we report a case of partial molar pregnancy in which a normal appearing foetus with diploid karyotype coexist. In this case a 24yr old primigravida at 20 week 3days gestation presented with 3-4 episodes of vaginal bleeding and generalised swelling of body since one month. On evaluation she was found to have moderate anaemia, proteinuria, raised serum β hcg and USG showed a single live foetus with thickened cystic placenta covering the internal os. After counselling patient was put up for hysterotomy. The product of conception and placenta were sent for histopathology and karyotyping which confirmed partial hydatidiform mole with trisomy 21 foetus. Patient had uneventful post op period and was followed up with serial β hcg measurement which fell to undetectable levels within two months. 

scholarly journals Partial Mole with a Coexistent Viable Fetus—A Clinical Dilemma: A Case Report with Review of Literature

2014 ◽  
Vol 6 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Archana D Rathod ◽  
SP Pajai ◽  
A Gaddikeri
Keyword(s):  
Case Report ◽  
Normal Pregnancy ◽  
Gestational Trophoblastic Disease ◽  
Review Of Literature ◽  
Female Fetus ◽  
Diploid Female ◽  
Trophoblastic Diseases ◽  
Partial Mole ◽  
Gestational Trophoblastic Diseases ◽  
Clinical Dilemma

ABSTRACT Gestational trophoblastic disease encompasses a diverse group of lesions. If molar changes in the placenta are known along with an alive fetus, then situation is difficult for both obstetrician and parents. On one hand, there may be a normal pregnancy whereas on the other hand the mother may be threatened by numerous complications caused by the hydatid mole, if the pregnancy is continued. We present successfully managed case of partial molar pregnancy with an alive fetus at 1st stage of preterm labor with premature rupture of membranes with anemia with a live diploid female fetus with good neonatal out come. Follow-up till 1 year showed no progression to malignant gestational trophoblastic diseases. How to cite this article Rathod AD, Pajai SP, Gaddikeri A. Partial Mole with a Coexistent Viable Fetus—A Clinical Dilemma: A Case Report with Review of Literature. J South Asian Feder Obst Gynae 2014;6(1):51-55.

scholarly journals An invasive mole with pulmonary metastases in a 55-year-old postmenopausal Syrian woman: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sawsan Ismail ◽  
Karen Mikhael ◽  
Nehad Salloum ◽  
Zuheir Alshehabi
Keyword(s):  
Emergency Department ◽  
Postmenopausal Women ◽  
Clinical Laboratory ◽  
Pulmonary Metastases ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases ◽  
History Of ◽  
Invasive Mole

Abstract Background Invasive mole is a subtype of gestational trophoblastic neoplasms (GTNs) that usually develops from the malignant transformation of trophoblastic tissue after molar evacuation. Invasive moles mostly occur in women of reproductive age, while they are extremely rare in postmenopausal women. Case presentation We present the case of a 55-year-old postmenopausal Syrian woman who was admitted to the emergency department at our hospital due to massive vaginal bleeding for 10 days accompanied by constant abdominal pain with diarrhea and vomiting. Following clinical, laboratory and radiological examination, total hysterectomy with bilateral salpingo-oophorectomy was performed. Histologic examination of the resected specimens revealed the diagnosis of an invasive mole with pulmonary metastases that were diagnosed by chest computed tomography (CT). Following surgical resection, the patient was scheduled for combination chemotherapy. However, 2 weeks later the patient was readmitted to the emergency department due to severe hemoptysis and dyspnea, and later that day the patient died in spite of resuscitation efforts. Conclusion Although invasive moles in postmenopausal women have been reported previously, we believe our case is the first reported from Syria. Our case highlights the difficulties in diagnosing invasive moles in the absence of significant history of gestational trophoblastic diseases. The present study further reviews the diagnostic methods, histological characteristics and treatment recommendations.

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