A Rare Case of Early Transformation of Gestational Trophoblastic Neoplasia Following Molar Pregnancy

Abstract

Patient: Female, 19-year-old Final Diagnosis: Gestational thropoblastic neoplasia Symptoms: Bleeding Medication:— Clinical Procedure: Curettage Specialty: Obstetrics and Gynecology • Oncology Objective: Rare disease Background: Gestational trophoblastic disease (GTD) encompasses a group of disorders that arise from abnormal growth of trophoblastic tissue. The spectrum of GTD includes 2 major groups: benign and malignant. The benign form is a hydatidiform mole, either complete or partial; the malignant forms, referred to as gestational trophoblastic neoplasia (GTN), consist of invasive moles, choriocarcinomas, placental site trophoblastic tumors, and epithelioid trophoblastic tumors. Most patients who undergo evacuation of a hydatidiform mole by curettage have a disease-free period before a new tumor develops that can be considered malignant. In rare cases, metastasis occurs rapidly and manifests coincidentally before the hydatidiform mole can be evacuated. Case Report: A 19-year-old woman in Bandung City, West Java, Indonesia, was diagnosed with a molar pregnancy with early evidence of a mass in her vagina that was suspicious for stage II GTN. The early emergence of a vaginal mass was a rare case of early transformation of a molar pregnancy into GTN. Conclusions: Careful evaluation is warranted of patients with characteristics typical of an intrauterine molar pregnancy who have an early presentation of a vaginal mass because of the possibility that the diagnosis could be GTN.

Study of vesicular mole and its outcomes

“…According to Green top guidelines no 38 and New Zealand GTD guidelines 2018 prophylactic chemotherapy is not recommended. 12 According to some studies 3,10,[12][13][14][15][16][17] the risk of GTD in patients with molar pregnancy was decreased if treated with prophylactic chemotherapy after surgery. However, serial hCG monitoring is still needed as prophylactic chemotherapy does not drop the risk to zero.…”

Renal effects of hydatiform mole and choriocarcinoma

“…Choriocarcinoma is a modern variant of gestational trophoblastic neoplasia, a severe type of malignancy. Choriocarcinoma accounts for about 1% of all gestational malignancies and displays osteoclastic activity frequently (30)(31)(32). Increased hCG levels are observed in 95% of women with choriocarcinoma, causing proteinuria.…”