A rare case of complete hydatidiform mole with prolonged evolution – clinical case
M. Akad, R. Socolov, R. Bălan, D. Popovici, E. Crauciuc, R. Covali, F. Akad, T. Buțureanu, A.M. Apetrei, A. Andriucă, D. Socolov
Rezumat: Introduction. Hydatidiform mole, also known as molar
pregnancy, represents a gestational trophoblastic disease
that originates in the placental tissue and has the capacity
of producing metastasis. Hydatidiform mole can be divided
into two specific types: complete and partial mole.
Complete hydatidiform mole is characterized by high levels
of beta-HCG and in 90% of cases it has a 46XX karyotype,
while the other 10% is represented by a 46XY karyotype.
Partial hydatidiform moles usually have a 69XXX or 69XXY
karyotype. Materials and method. A 20-year-old female
patient presented to the “Elena Doamna” Clinical Hospital
of Obstetrics and Gynecology, Iaşi, by transfer from another
medical care unit, in April 2023, with the diagnosis of molar
pregnancy, hemorrhage, severe anemia, and with two caesareans
in her medical history. The clinical examination revealed
an enlarged uterus surpassing the umbilicus, and at
abdominal palpation, a large, ovoidal, smooth mass could
be felt, with its longitudinal axis surpassing the umbilicus
with 2-3 cm. Pelvic ultrasound examination suggested
the diagnosis of complete hydatidiform mole. The evacuation
of the pregnancy was performed by aspiration of the uterine
cavity under ultrasound guidance, and with continuous
intravenous administration of oxitocine. Results. The
patient had a favorable evolution, the post-surgery
pelvic ultrasound showing an empty uterus, accompanied
by an ovarian hyperstimulation syndrome. The results
from the pathological anatomy examination confirmed
our diagnosis. Conclusions. This case had a favorable
evolution, but the patient’s follow-up was difficult. The
particularity of this case consists in its prolonged evolution
without symptoms, this being the first medical consultation
throughout patient’s entire pregnancy. Cuvinte cheie: hydatidiform mole, methotrexate, pelvic ultrasound.