Multiple metastatic gestational trophoblastic disease after a twin pregnancy with complete hydatidiform mole and coexisting fetus, following assisted reproductive technology: Case report and literature review

Nobuhara, Ichiro; Harada, Naoya; Haruta, Noriko; Higashiura, Yumi; Watanabe, Hideki; Watanabe, Shioka; Hisanaga, Hiroyasu; Sado, Toshiyuki

doi:10.1016/j.tjog.2018.06.020

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…Sebire et al reported that only four cases of GTN occurring in 77 cases of CHMCF pregnancies (5.2%) required multidrug combination chemotherapy [ 5 ], suggesting CHMCF does not present a high risk for GTN. However, previous case reports describe diagnoses of high-risk GTN after CHMCF or cases requiring multidrug combination chemotherapy for GTN (presumed to be high-risk GTN) [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ]. In six of 12 cases (50%), including the present case, single-agent chemotherapy was given as the initial chemotherapy for PTD.…”

Section: Discussionmentioning

confidence: 99%

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

Taira

Shimoji

Nakasone

et al. 2021

Case Reports in Women's Health

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A complete hydatidiform mole coexisting with a fetus (CHMCF) is a rare form of twin pregnancy. High-risk gestational trophoblastic neoplasia (GTN) can occur after a CHMCF pregnancy, although the frequency is low. In cases of GTN, the clinical diagnosis and that based on the International Federation of Gynecology and Obstetrics (FIGO) scoring system can differ. This case report concerns a patient with a choriocarcinoma that was initially diagnosed and treated as a low-risk stage III GTN following a live birth from a CHMCF pregnancy. We used short tandem repeat (STR) analysis to identify the causative pregnancy as the patient's earlier complete hydatidiform mole. Clinicians should anticipate a high-risk GTN when treating persistent trophoblastic disease (PTD) in patients with a non-typical course.

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Section: Discussionmentioning

confidence: 99%

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

Taira

Shimoji

Nakasone

et al. 2021

Case Reports in Women's Health

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“…A rather rare entity is the presence of a twin pregnancy with a molar pregnancy (either CHM or PHM) and coexisting fetus. Several case reports and series have been published in this subject matter [6], [7], [8], including metastasis during pregnancy [9,2] or after pregnancy [10], [11], [12], [13], [14], [15]. A twin pregnancy with CHM can be differentiated from a twin pregnancy with PHM by the presence of viable fetus as in the latter case the fetus is usually anomalous or dead.…”

Section: Discussionmentioning

confidence: 99%

Twin pregnancy with metastatic complete molar pregnancy and coexisting live fetus

Odedra¹,

MacEachern²,

Elit³

et al. 2020

Radiology Case Reports

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We present a case of a 34-year old G1P0 female with twin-gestation and positive prenatal screening. Initial ultrasounds demonstrated a normal live fetus with an indeterminate but persistent placental lesion. The patient presented at 23 weeks of gestational age with vaginal bleeding. On examination, a 2 cm vaginal lesion was identified. Further cross-sectional imaging demonstrated a normal appearing fetus with a mixed solid and cystic placental lesion as well as an additional lesion in the vagina. Metastatic workup revealed diffuse pulmonary metastases. Intravascular embolization was carried out to minimize the bleeding from the vaginal lesion, followed by the delivery of the fetus with an urgent Caesarean section and treatment with chemotherapy. Pathology and genetics testing confirmed diagnosis of a complete molar pregnancy with a coexisting live fetus. This case highlights the importance of any unexpected findings within the placenta or the uterus in a pregnant patient. The radiologist should maintain a high index of suspicion for gestational trophoblastic disease in such cases, communicate clearly with the clinical team and suggest appropriate additional imaging.

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“…Anteriormente, el manejo de la gestación gemelar compuesto por mola hidatiforme completa y feto vivo consistía en la terminación temprana del embarazo (5,6). Sin embargo, la continuidad de la gestación se ha convertido en una opción viable en el siglo XXI, apoyada por una serie de casos japoneses en la que los investigadores notaron que el riesgo de malignidad no cambia con la edad gestacional avanzada, pero es importante la adecuada monitorización de complicaciones (7).…”

Section: Discussionunclassified

Embarazo gemelar con mola hidatiforme completa y feto coexistente

Silva¹,

Ciodaro²

2020

Rev. colomb. radiol.

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Dentro del espectro de enfermedad trofoblástica gestacional, una de las entidades menos frecuente es la coexistencia, en un embarazo gemelar bicorial biamniótico, de una mola hidatiforme completa y un feto viable normal. El diagnóstico de esta condición requiere un cuidadoso examen ecográfico, con el fin de descartar la presencia de dos importantes patologías que componen los principales diagnósticos diferenciales en estos casos: la mola hidatiforme parcial y la displasia mesenquimal placentaria. Siguiendo de forma acuciosa el protocolo de ecografía obstétrica, y utilizando los conocimientos como explorador, se puede realizar el diagnóstico con precisión, diferenciando entre estas dos entidades. A continuación, se presenta el caso de un embarazo gemelar con mola hidatiforme completa y feto normal coexistentes, un hallazgo poco frecuente. Se realiza revisión de la literatura en cuanto a manejo y seguimiento de esta entidad dada su propensión a causar complicaciones en la gestación y a presentar comportamiento maligno

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Multiple metastatic gestational trophoblastic disease after a twin pregnancy with complete hydatidiform mole and coexisting fetus, following assisted reproductive technology: Case report and literature review

Abstract: Cases of CHMCF following ART may also have higher malignant potential and higher risk of GTD development and become more aggressive biologically. The clinical course of CHMCF after ART seems to be almost the same as that without ART based on the results of literature review.

Cited by 17 publications

References 16 publications

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

Twin pregnancy with metastatic complete molar pregnancy and coexisting live fetus

Embarazo gemelar con mola hidatiforme completa y feto coexistente

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