Presentation Invasive Mole After Normal Pregnancy: A Very Rare Case Report
-
Afsaneh Tehranian
,
Akram Ghahghaei-nezamabadi
,
Marzieh Vahid –dastjerdi
,
Sophia Esalatmanesh
,
Akram Seifollahi
Abstract
Gestational trophoblastic neoplasia (GTN) is a rare neoplasm and is a spectrum of proliferative disorders of placenta. Invasive mole is a subtype of GTN that almost always arises after molar pregnancy. This report presents a 35-year-old woman with an atypical presentation of invasive mole after a normal pregnancy. The patient presented with a complaint of vaginal bleeding after normal vaginal delivery. Invasive mole was diagnosed based on findings of imaging and elevated beta human chorionic gonadotropin (ß-hCG) levels. Hysterectomy was finally decided upon due to severe vaginal bleeding and the patient’s request. Although GTN occurs after normal delivery, the patient recovered without receiving chemotherapy. It is important to consider all subtypes of GTN as a differential diagnosis of patients with abnormal postpartum bleeding and elevated ß-hCG levels even after a normal pregnancy.
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[6] Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. American 2010;203(6):531- 39. https://doi.org/10.1016/j.ajog.2010.06.073
[7] Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Diagnosis and management of gestational trophoblastic disease: 2021 update. Int J Gynaecol Obstet. 2021;155 Suppl 1:86-93. https://doi.org/10.1002/ijgo.13877
[8] Berek JS. Berek & Novak’s gynecology. 16th ed. Philadelphia: Wolters Kluwer; 2020.
[9] Raguraman S, Muhunthan K, Kabileshan P. Case Report: Rare presentation of invasive mole following term pregnancy after assisted reproduction. Obstet Gynecol Cases Rev. 2021;8(5):210. https://doi.org/10.23937/2377-9004/1410210
[10] Horowitz NS, Adelman MR, Burke W. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecologic oncology. 2021;163(3):605- 13. https://doi.org/10.1016/j.ygyno.2021.10.003
Adelman MR, Burke W. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecologic oncology. 2021;163(3):605- 13. https://doi.org/10.1016/j.ygyno.2021.10.003
[12] Hanna RK, Soper JT. The role of surgery and radiation therapy in the management of gestational trophoblastic disease. Oncologist. 2010;15(6):593-600. https://doi.org/10.1634/ theoncologist.2010-0065
[13] Clark RM, Nevadunsky NS, Ghosh S, Goldstein DP, Berkowitz RS. The evolving role of hysterectomy in gestational trophoblastic neoplasia at the New England Trophoblastic Disease Center. J Reprod Med. 2010;55(5-6):194-8.
[14] Suzuka K, Matsui H, Iitsuka Y, Yamazawa K, Seki K, Sekiya S. Adjuvant hysterectomy in low-risk gestational trophoblastic disease. Obstet Gynecol. 2001;97(3):431-4. https://doi. org/10.1016/s0029-7844(00)01169-8
[2]Borella F, Cosma S, Ferraioli D, Preti M, Gallio N, Valabrega G, et al. From Uterus to Brain: An Update on Epidemiology, Clinical Features, and Treatment of Brain Metastases From Gestational Trophoblastic Neoplasia. Front Oncol. 2022;12:859071. https:// doi.org/10.3389/fonc.2022.859071
[3] Aminimoghaddam S, Maghsoudnia A. Unusual Presentation of Invasive Mole: A Case Report. J Reprod Infertil. 2017;18(1):205- 09.
[4] Ngu SF, Ngan HYS. Surgery including fertility-sparing treatment of GTD. Best Pract Res Clin Obstet Gynaecol. 2021;74:97-108. https://doi.org/10.1016/j.bpobgyn.2020.10.005
[5]Thomakos N, Rodolakis A, Belitsos P, Zagouri F, Chatzinikolaou I, Dimopoulos A-M, et al. Gestational trophoblastic neoplasia with retroperitoneal metastases: A fatal complication. World Journal of Surgical Oncology. 2010;8(1):114. https://doi. org/10.1186/1477-7819-8-114
[6] Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. American 2010;203(6):531- 39. https://doi.org/10.1016/j.ajog.2010.06.073
[7] Ngan HYS, Seckl MJ, Berkowitz RS, Xiang Y, Golfier F, Sekharan PK, et al. Diagnosis and management of gestational trophoblastic disease: 2021 update. Int J Gynaecol Obstet. 2021;155 Suppl 1:86-93. https://doi.org/10.1002/ijgo.13877
[8] Berek JS. Berek & Novak’s gynecology. 16th ed. Philadelphia: Wolters Kluwer; 2020.
[9] Raguraman S, Muhunthan K, Kabileshan P. Case Report: Rare presentation of invasive mole following term pregnancy after assisted reproduction. Obstet Gynecol Cases Rev. 2021;8(5):210. https://doi.org/10.23937/2377-9004/1410210
[10] Horowitz NS, Adelman MR, Burke W. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecologic oncology. 2021;163(3):605- 13. https://doi.org/10.1016/j.ygyno.2021.10.003
Adelman MR, Burke W. Epidemiology, diagnosis, and treatment of gestational trophoblastic disease: A Society of Gynecologic Oncology evidenced-based review and recommendation. Gynecologic oncology. 2021;163(3):605- 13. https://doi.org/10.1016/j.ygyno.2021.10.003
[12] Hanna RK, Soper JT. The role of surgery and radiation therapy in the management of gestational trophoblastic disease. Oncologist. 2010;15(6):593-600. https://doi.org/10.1634/ theoncologist.2010-0065
[13] Clark RM, Nevadunsky NS, Ghosh S, Goldstein DP, Berkowitz RS. The evolving role of hysterectomy in gestational trophoblastic neoplasia at the New England Trophoblastic Disease Center. J Reprod Med. 2010;55(5-6):194-8.
[14] Suzuka K, Matsui H, Iitsuka Y, Yamazawa K, Seki K, Sekiya S. Adjuvant hysterectomy in low-risk gestational trophoblastic disease. Obstet Gynecol. 2001;97(3):431-4. https://doi. org/10.1016/s0029-7844(00)01169-8
| Files | ||
| Issue | Vol 8 No 4 (2023): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i4.14575 | |
| Keywords | ||
| Gestational trophoblastic neoplasia nvasive mole Normal pregnancy | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Tehranian A, Ghahghaei-nezamabadi A, Vahid –dastjerdi M, Esalatmanesh S, Seifollahi A. Presentation Invasive Mole After Normal Pregnancy: A Very Rare Case Report. CRCP. 2024;8(4):155-158.
