Diagnosis and treatment of an atypical invasive mole: A case report

Abstract

Gestational trophobalstic neoplasia (GTN) is spectrum of trophoblastic diseases that includes invasive mole, placental site trophoblastic tumor (PSTT),epitheloid trophoblastic tumor (ETT) and choriocarcinoma. The diagnosis of invasive mole is mostly based on clinical findings. In this paper, we report a 40-year-old woman with atypical presentation of invasive mole. She had no complaint, and was incidentally diagnosed after 9 months of amenorrhea during a hospital visit. Clinical diagnosis was difficult due to nonspecific ultrasound findings and low-level b-hCG. Dilatation and curretage failed to obtain sufficient pathologic information, and chemoresistance to methotrexate complicated the treatment. Hysterectomy was finally decided due to progressing uterine enlargement, even after the normalization of serum b-hCG.