MRI of complete hydatidiform mole with normal hCG and viable intrauterine pregnancy

Abstract

Introduction: Coexistent complete mole with a concomitant live fetus is a rare occurrence. Initially it may be identified by Ultrasound (US). Magnetic resonance imaging (MRI) is a useful alternative to US because MRI depicts the molar mass as separate from the live fetus, its monochorionic monoamniotic gestational sac and normal appearing placenta.Case Report: A rare case of complete hydatidiform mole with concomitant live intrauterine pregnancy and normal level of serum human chorionic gonadotropin (hCG) is reported. Obstetrical US showed an indeterminate multicystic lenticular shaped uterine mass without ovarian theca lutein cysts. Magnetic resonance imaging showed the molar mass as separate from the live fetus within its gestational sac and a normal placenta. Although partial mole was favored because of the normal hormone level, pathology showed a complete mole after delivery of a live fetus. Conclusion:This case highlights the utility of MRI for diagnosis and optimized management if US and clinical findings are indeterminate.