The occurrence of complete hydatidiform mole with co-existing fetus complicated by invasive mole: A case report

doi:10.3969/j.issn.1004-583X.2024.05.011

Abstract

Abstract:

Objective To explore the pathogenesis, clinical characteristics and treatment methods of complete hydatidiform mole with co-existing fetus (CHMCF). Methods A retrospective analysis was conducted on the diagnosis, treatment, and pregnancy outcome of a case involving CHMCF complicated by invasive mole, along with a review of related literature. Results The patient had a spontaneous pregnancy following ovulation induction treatment, with an ultrasound during pregnancy confirmed twin pregnancy complicated by hydatidiform mole. A full-term newborn was delivered by cesarean section. Combining clinical presentation, imaging examinations, histopathological characteristics and immunohistochemistry, the CHMCF diagnosis was confirmed. A 2-month follow-up after cesarean section revealed the diagnosis of an invasive mole (Ⅲ:2). Clinical remission was achieved after receiving 7 courses of single-agent methotrexate (MTX) chemotherapy. Conclusion Management of a twin pregnancy complicated by hydatidiform mole should be individualized, especially in cases involving CHMCF complicated by invasive mole.

Key words: twin pregnancy, complete hydatidiform mole, invasive mole, complete hydatidiform mole with co-existing fetus

CLC Number:

R737.33

Liu Liting, Wang Jian, Xiao Yanlai, Zhang Yiwei. The occurrence of complete hydatidiform mole with co-existing fetus complicated by invasive mole: A case report[J]. Clinical Focus, 2024, 39(5): 450-454.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.05.011

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I5/450

Figures/Tables 4

Fig. 1 Ultrasound image of a pregnant woman at 36+ weeks of pregnancy (sagittal section)

Fig. 2 Fetus delivered by a pregnant woman a. Fetus: weight 2, 810 g, Apgar score 10 points, no deformity in appearance; b. Gross appearance of the placenta: size 18 cm×16 cm×2.5 cm, part of the maternal surface grayish-yellow in color, ranging 5 cm×3 cm, with the umbilical cord attached; c. Gross appearance of hydatidiform tissue: size approximately 14 cm×11 cm×7.5 cm, with several blisters on it, 0.5~2.0 cm in diameter

Fig. 3 Pathological examination of the placenta a. Local infarction of the placental tissue with a small amount of calcification; b. Mole-like tissue, consistent with complete mole with a large amount of necrosis

Fig. 4 Pelvic magnetic MRI The myometrium is irregular in shape, with cystic and lamellar T2 high signal, especially on the right side, and low signal in parts. The endometrium is unclearly displayed, with disordered structure and uneven signal (sagittal view)

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