Complete Molar Pregnancy in Postmenopausal Woman: A Rare Case Report

Abstract

BACKGROUND: Molar pregnancy, the form of the gestational trophoblastic disease (GTD), generally occurs in women of the reproductive age group, and rarely occurs in postmenopausal women. To present a rare case of molar pregnancy in a postmenopausal woman. CASE REPORT: A multiparous woman aged 54 years was referred to the outpatient department at Raja Ahmad Tabib General Hospital of Riau Island, Indonesia with the main symptoms of nausea and vomiting profusely with 1 month before, lower abdominal pain, lump in the abdomen, abnormal vaginal bleeding, and a positive urine pregnancy test. Her last menstrual bleeding was 14 months ago. Physical examination found stable hemodynamic within blood pressure 150/95 mmHg. Laboratory results showed Hb 11.7 g/dL, positive urine pregnancy test, and serum β-HCG 292,876.1 mIU/mL. Ultrasound examination showed a vesicular pattern in the uterine cavity without fetal tissue. The patient was managed by elective total abdominal bilateral hysterectomy salpingo-oophorectomy. The intraoperative finding was softened, enlarged uterus size of 14–16 weeks of pregnancy, and no local spreading of disease. The patient was discharged on the 3 day after surgery. CONCLUSION: Even though molar pregnancy is rare, it can occur in the postmenopausal woman. Therefore, GTD has remained in the differential diagnosis of postmenopausal bleeding which can prevent delay in diagnosis and management. Definitive treatment with total abdominal hysterectomy has been chosen in menopausal women who do not wish to preserve their fertility and prevent any malignant sequelae.