Heterotopic pregnancy: a case report of intrauterine hydatidiform mole with tubal pregnancy

Abstract

We herein report a rare case of simultaneous intrauterine molar pregnancy and tubal pregnancy. A woman of childbearing age who had never been pregnant underwent an ultrasound examination 70 days after the onset of menopause. She had a history of ovulation induction. The ultrasound findings suggested a partial hydatidiform mole. She was then pathologically confirmed to have a complete hydatidiform mole after uterine suction dilation and curettage. On postoperative day 4, an ultrasound examination before discharge showed an inhomogeneous mass in the left adnexal region with mild lower abdominal pain. On postoperative day 17, the blood human chorionic gonadotropin level did not drop as expected, and a follow-up examination still indicated a mass in the left adnexal region. We were unable to rule out an ectopic hydatidiform mole. Hysteroscopy with laparoscopic exploration of the left adnexal mass and salpingotomy suggested a diagnosis of intrauterine hydatidiform mole combined with left tubal pregnancy.

Keywords: Heterotopic pregnancy; case report; dilation and curettage; human chorionic gonadotropin; intrauterine hydatidiform mole; tubal pregnancy; ultrasonography.

Figure 1.

Diagnostic imaging and surgical findings. (a) Pelvic ultrasound images. (b) Pelvic magnetic resonance images. (c, d) Findings of laparoscopic exploration. (e) Pregnancy tissue in the fallopian tube and (f) histopathological section of left tubal pregnancy (hematoxylin and eosin, 20×).