Complete hydatidiform mole in a 52-year-old postmenopausal woman: A case report and literature review

Complete Molar Pregnancy in a 50-Year-Old Postmenopausal Woman

Gestational trophoblastic diseases (GTDs) are usually seen in women of reproductive age, but rarely, they can also be observed in postmenopausal women. In a postmenopausal woman presenting with abnormal vaginal bleeding, the differential diagnosis of gestational trophoblastic disease using histopathological, clinical, and radiological methods is important to prevent delays in treatment. A 50-year-old female patient presented to our clinic with complaints of abnormal vaginal bleeding. Ultrasound imaging revealed a mass lesion in the endometrial cavity consistent with a molar pregnancy. Furthermore, the biochemical value of beta-human chorionic gonadotropin (B-HCG) was 353,761 IU/L, supporting the diagnosis. For further evaluation, the patient underwent computed tomography and magnetic resonance imaging. Additional imaging supported the diagnosis. Based on these results, the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathology results confirmed a complete molar pregnancy. In this case report, we present the clinical and radiological approach in the differential diagnosis of gestational trophoblastic disease in a 50-year-old female patient.

Atypical presentation of hyperthyroidism complicated complete hydatidiform mole in a 24-year-old female: a case report

Introduction and importance

Molar pregnancy is the most common type of gestational trophoblastic disease. It manifests as vaginal bleeding, accompanied by high levels of β-human chorionic gonadotropin (β-HCG). This case aims to highlight the importance of considering gestational trophoblastic disease as a potential diagnosis and its serious complications.

Case presentation

A 24-year-old female presented with vomiting, nausea, and no complaint of vaginal bleeding. Laboratory tests indicated hyperthyroidism as a complication requiring challenging preoperative prophylactic management. Initially, the patient underwent suction and curettage, but a total hysterectomy had to be performed later. The histological study concluded with the diagnosis of a complete hydatidiform mole. Post-surgery follow-up evaluations revealed high blood pressure values, and the patient was appointed for further cardiology assessment.

Discussion and conclusion

Although uncommon, complications of a molar pregnancy include anaemia, severe cardiac distress, and hyperthyroidism. Trophoblastic Hyperthyroidism is a result of extremely high levels of β-HCG levels due to molecular cross-reactivity. History, clinical examination, and ultrasound, in addition to measuring β-HCG levels, could all help in diagnosing a molar pregnancy, but the definitive diagnosis is based on histopathology and a karyotype study. Management procedures include dilation, suction and curettage, and hysterectomy. The treatment depends on the patient's age, desire for future pregnancies, and risk of developing gestational trophoblastic neoplasia. A follow-up with serial β-HCG measurement is recommended to monitor possible complications. Attaining and maintaining euthyroidism is a life-saving procedure before molar pregnancy surgery. Methimazole, Propranolol, Lugol's iodine, and hydrocortisone can all be used in the prophylactic management of the thyroid storm.