Gestational Trophoblastic Disease
Invasive Mole: Clinical Presentation and Management
Invasive mole is a rare but serious form of gestational trophoblastic disease that requires prompt diagnosis and treatment. Management includes chemotherapy and, in severe cases, surgical intervention.
Gestational Trophoblastic Disease: Invasive Mole
Overview
Invasive mole is a rare but serious form of gestational trophoblastic disease (GTD) characterized by the invasion of molar tissue into the uterine myometrium and occasionally beyond.
Clinical Presentation
Patients typically present with abnormal uterine bleeding, persistently elevated β-hCG levels, and sometimes uterine enlargement. In some cases, symptoms of metastasis, such as hemoptysis or neurological deficits, may be observed.
Diagnosis
- β-hCG Monitoring: Persistently high levels post-molar evacuation.
- Ultrasonography: Shows echogenic intrauterine mass with Doppler evidence of vascular invasion.
- Histopathology: Confirms excessive trophoblastic proliferation with invasion into myometrial tissue.
Management
Management typically involves chemotherapy with methotrexate or actinomycin-D, depending on disease severity. In cases of extensive invasion or failure of medical treatment, surgical intervention including hysterectomy may be required.
Prognosis
With early diagnosis and appropriate treatment, the prognosis of invasive mole remains favorable, with a high rate of complete remission.
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