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Case Reports
. 2021 May 11:22:e930789.
doi: 10.12659/AJCR.930789.

A Rare Case of Early Transformation of Gestational Trophoblastic Neoplasia Following Molar Pregnancy

Febia Erfiandi  1 , Kemala Isnainiasih Mantilidewi  1 , Yudi Mulyana Hidayat  1 , Ali Budi Harsono  1 , Dodi Suardi  1 , Siti Salima  1 , Andi Kurniadi  1 , Indah P Islami  1 , Hasrayati Agustina  2 , Birgitta Maria Dewayani  2 , Aisyah Shofiatun Nisa  1 , Huda Toriq  1
Affiliations
Case Reports

A Rare Case of Early Transformation of Gestational Trophoblastic Neoplasia Following Molar Pregnancy

Febia Erfiandi et al. Am J Case Rep. .

Abstract

BACKGROUND Gestational trophoblastic disease (GTD) encompasses a group of disorders that arise from abnormal growth of trophoblastic tissue. The spectrum of GTD includes 2 major groups: benign and malignant. The benign form is a hydatidiform mole, either complete or partial; the malignant forms, referred to as gestational trophoblastic neoplasia (GTN), consist of invasive moles, choriocarcinomas, placental site trophoblastic tumors, and epithelioid trophoblastic tumors. Most patients who undergo evacuation of a hydatidiform mole by curettage have a disease-free period before a new tumor develops that can be considered malignant. In rare cases, metastasis occurs rapidly and manifests coincidentally before the hydatidiform mole can be evacuated. CASE REPORT A 19-year-old woman in Bandung City, West Java, Indonesia, was diagnosed with a molar pregnancy with early evidence of a mass in her vagina that was suspicious for stage II GTN. The early emergence of a vaginal mass was a rare case of early transformation of a molar pregnancy into GTN. CONCLUSIONS Careful evaluation is warranted of patients with characteristics typical of an intrauterine molar pregnancy who have an early presentation of a vaginal mass because of the possibility that the diagnosis could be GTN.

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Conflict of interest statement

Conflict of interest: None declared

Conflict of Interest

None.

Figures

Figure 1.
Figure 1.
(A) Normal chest X-ray. (B) Abdominal ultrasound showing snowstorm appearance.
Figure 2.
Figure 2.
(A) The vaginal mass before perforation. (B) Incision and evacuation of the vaginal mass. (C) Presence of vesicular-like tissue inside the vaginal mass. (D) Appearance after evacuation of the vaginal mass.
Figure 3.
Figure 3.
Histopathology of complete mole. Scale bar=100 µm.
Figure 4.
Figure 4.
(A) Histopathologic reevaluation of the vaginal mass. (B) Histopathologic reevaluation of the uterine mass. (C) p53 immunohistochemistry of the molar mass. Scale bars=100 µm.
Figure 5.
Figure 5.
(A) X-ray taken on postoperative day 2 showing bilateral pneumonia. (B) X-ray taken on postoperative day 4 showing pulmonary edema.
See this image and copyright information in PMC

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References

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