Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo  

Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo

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作  者:Julien Bwama De-Joseph Kakisingi Mibi Nsenga Bin Musa Jeff Andrea Mbozi Déborah Kambonesa Salire Dieudonné Kakusu Christine Amisi Tina Aroni Toto Tchass Chasinga Baharanyi Denis Mukwege Mukengere Olivier Nyakio Ngeleza Julien Bwama;De-Joseph Kakisingi Mibi;Nsenga Bin Musa;Jeff Andrea Mbozi;Déborah Kambonesa Salire;Dieudonné Kakusu;Christine Amisi Tina;Aroni Toto;Tchass Chasinga Baharanyi;Denis Mukwege Mukengere;Olivier Nyakio Ngeleza(Department of Gynaecology-Obstetrics, Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo;Gynaecology-Obstetrics Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo;Saint Vincent Hospital, Bukavu, Democratic Republic of Congo;Medical Imaging Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo;Anatomopathology Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo;Panzi Foundation, Bukavu, Democratic Republic of Congo;Department of Gynaecology-Obstetrics, Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo;Department of Gynaecology-Obstetrics, Faculty of Medicine, University of Kindu, Kindu, Democratic Republic of Congo)

机构地区:[1]Department of Gynaecology-Obstetrics, Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, Democratic Republic of Congo [2]Gynaecology-Obstetrics Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo [3]Saint Vincent Hospital, Bukavu, Democratic Republic of Congo [4]Medical Imaging Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo [5]Anatomopathology Department, Panzi General Referral Hospital, Bukavu, Democratic Republic of Congo [6]Panzi Foundation, Bukavu, Democratic Republic of Congo [7]Department of Gynaecology-Obstetrics, Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of Congo [8]Department of Gynaecology-Obstetrics, Faculty of Medicine, University of Kindu, Kindu, Democratic Republic of Congo

出  处:《Open Journal of Obstetrics and Gynecology》2024年第7期1010-1017,共8页妇产科期刊(英文)

摘  要:Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

关 键 词:Complete Hydatidiform Mole MENOPAUSE Β-HCG Panzi Bukavu DRC 

分 类 号:R73[医药卫生—肿瘤]

 

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