IMR Press / EJGO / Volume 26 / Issue 2 / pii/2005133

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research

A case of metastasizing invasive hydatidiform mole. Is less - less good? Review of the literature with regard to adequate treatment

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1 Department of Obstetrics and Gynecology; Department of Pathology2; Department of Radiology3, University of Wuerzburg, Germany
Eur. J. Gynaecol. Oncol. 2005, 26(2), 158–162;
Published: 10 April 2005
Abstract

Background: Patients with invasive hydatidiform moles (IHM) have a good prognosis. Even if disease has spread, monocytosta­tic treatment might be sufficient if the diagnosis has been histologically confirmed. Established classifications divide gestational tro­phoblastic disease (GTD) including choriocarcinoma into cases with “high” and “low” risk. Without respect to histology “high-risk” cases are recommended to obtain polychemotherapy. Case: A 40-year-old nullipara underwent hysterectomy for persistent vaginal bleeding after she had already been treated with curettage for hydatidiform mole. An IHM was pathohistologically confirmed. There were no signs of pulmonary spread or other metastases at the time of surgery. Postsurgically persistent H-hCG levels lead to thorough staging, which revealed multiple pul­monary metastases and a vaginal metastasis. Despite metastasizing GTD with poor prognosis criteria she was treated with single agent therapy. Eight cycles of two weekly methotrexate (MTX) were administered. All sites of metastases responded and our patient is, till fine after one year of follow-up. Conclusion: With respect to this and other reports monochemotherapy can be a reasonable primary treatment for metastatic IHM.

Keywords
Gestational trophoblastic disease
Invasive hydatidiform mole
Chemotherapy
Review
Case report
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