ABSTRACT
@#Gestational trophoblastic neoplasia (GTN), a malignancy arising from trophoblastic tissue of pregnancy, is an aggressive disease process with a high probability of metastasis if left untreated. This is a case report on metastatic invasive mole arising from a molar pregnancy. Four months after suction curettage, a mass was noted in the left broad ligament on exploratory laparotomy with intact uterine serosa. Clinical presentation, biochemical, and radiological parameters led to a diagnosis of persistent trophoblastic disease. Histopathological findings also confirmed the diagnosis. Prompt chemotherapy was given after removal of the left intraligamentary mass, and subsequent response to treatment was documented. We report a case demonstrating a different clinical presentation of invasive mole and its potential to metastasize to the broad ligament without uterine perforation or direct extension.
ABSTRACT
Background@#Administration of chemotherapy to prevent postmolar gestational trophoblastic neoplasia was first implemented in the 1960’s. However, its use has remained controversial.@*Objectives@#This study aimed to describe the effect of chemoprophylaxis in preventing progression of hydatidiform mole to gestational trophoblastic neoplasia among patients managed in a tertiary hospital in Davao City from 2011 to 2015.@*Materials & Method@#This retrospective cross-sectional study evaluated 123 cases of hydatidiform mole who were managed at a tertiary hospital in Davao City from the years 2011 to 2015. The patients’ charts were retrieved to get the clinicodemographic profile, progression to gestational trophoblastic neoplasia, and occurrence of adverse effects secondary to chemoprophylaxis. Patients with rising or plateauing beta human chorionic gonadotropin titer were identified within the 3-year period from molar evacuation. Collected data were analyzed using frequency and percentage distribution.@*Results@#The mean age of the patients was 30.5 years, 24% of whom were noted in women more than 40 years of age. The average age of gestation on admission was 14.89 weeks. All patients had a histopathologic diagnosis of complete mole and at least one risk factor for developing postmolar gestational trophoblastic neoplasia. Patients did not experience any significant side effect to chemoprophylaxis. None of the patients developed gestational trophoblastic neoplasia within the 3-year period of monitoring.@*Conclusion@#The administration of chemoprophylaxis to patients diagnosed with hydatidiform mole may be effective against the development of postmolar gestational trophoblastic neoplasia.