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Unusual Presentation of Invasive Mole: A Case Report.

ABSTRACT: BACKGROUND:Invasive mole is responsible for most cases of localized gestational trophoblastic neoplasia. Gestational trophoblastic disease describes a number of gynecologic tumors that originate in trophoblastic layer including hydatidiform mole (complete or partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Invasive mole may arise from any pregnancy event although in most cases is diagnosed after molar pregnancy. Overall cure rate in low risk patients is nearly 100% and in high-risk patient 90%. In rare cases, molar tissue traverses thickness of myometrium and leads to perforation and acute abdomen and invasive mole infrequently metastasis. The best treatment option is chemotherapy (according to stage and score with single or multiple agent) and in patients that fertility is not the matter, hysterectomy can be done. CASE PRESENTATION:A 41 years old G3P2ab1 woman referred to Firouzgar hospital 2 months after curettage of molar pregnancy with vaginal bleeding and acute abdomen. In workup, HCG 224000 mIU/ml and evidence of metastasis was detected. Chemotherapy due to stage 3 and score 9 and surgery due to acute abdomen was done. This case was reported for its rarity. DISCUSSION:This case reported about ovarian metastasis and uterine rupture with acute abdomen and involvement of omentum in metastatic invasive mole. Lack of surveillance led to extensive morbidity. Management of this patient was successful. In follow up, she was free of disease without sequel of any kind for five years now.

SUBMITTER: Aminimoghaddam S

PROVIDER: S-EPMC5359859 | biostudies-literature | 2017 Jan-Mar

REPOSITORIES: biostudies-literature

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Unusual Presentation of Invasive Mole: A Case Report.

Aminimoghaddam Soheila S Maghsoudnia Andisheh A

Journal of reproduction & infertility 20170101 1

<h4>Background</h4>Invasive mole is responsible for most cases of localized gestational trophoblastic neoplasia. Gestational trophoblastic disease describes a number of gynecologic tumors that originate in trophoblastic layer including hydatidiform mole (complete or partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Invasive mole may arise from any pregnancy event although in most cases is diagnosed after molar pregnancy. Overall cure ...[more]

PMID: 28377901

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Project description:INTRODUCTION:Cyclopia (alobar holoprosencephaly) (OMIM% 236100) is a rare and lethal complex human malformation, resulting from incomplete cleavage of prosencephalon into right and left hemispheres occurring between the 18th and the 28th day of gestation. Holoprosencephaly occurs in 1/16,000 live births, and 1/250 during embryogenesis. Approximately 1.05 in 100,000 births are identified as infants with cyclopia, including stillbirths. Cyclopia typically presents with a median single eye or a partially divided eye in a single orbit, absent nose, and a proboscis above the eye. Extracranial malformations described in stillbirths with cyclopia include polydactyl, renal dysplasia, and an omphalocele. The etiology of this rare syndrome, which is incompatible with life, is still largely unknown. Most cases are sporadic. Heterogeneous risk factors have been implicated as possible causes. CASE PRESENTATION:A live full-term baby with birth weight of 2900 g, product of cesarean section because of severe fetal bradycardia, was born at Prince Hashem Military Hospital - Zarqa city/Jordan. This newborn was the first baby to a non-consanguineous family, and a healthy 18-year-old mother, with no history of drug ingestion or febrile illnesses during pregnancy. Antenatal history revealed severe hydrocephalus diagnosed early by intrauterine ultrasound but the pregnancy was not terminated because of the lack of medical legitimization in the country. On examination, the newborn was found to have a dysmorphic face, with a median single eye, absence of nose, micrognathia, and a proboscis above the eye, all of which made cyclopia the possible initial diagnosis. Multiple unusual abdominal defects were present that include a huge omphalocele containing whole liver and spleen, urinary bladder extrophy, and undefined abnormal external genitalia, which called for urgent confirmation. Brain MRI was done and revealed findings consistent with alobar holoprosencephaly (cyclopia). CONCLUSION:Presentation of cyclopia is not fully exposed and new cyclopian syndromes still can appear. The prenatal diagnosis of cyclopia can be made early by ultrasound, and the awareness of the spectrum of sonographic findings of cyclopia can improve the accuracy of prenatal diagnosis. The legitimization of pregnancy termination for indexed cases in many countries around the world should be revised.

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Unusual Presentation of Invasive Mole: A Case Report.

Publications

Unusual Presentation of Invasive Mole: A Case Report.

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