Ectopic Complete Hydatidiform Mole Presenting as an Adnexal Tumor in a Postmenopausal Patient

Abstract

Hydatidiform mole (HM) is rare in postmenopause, with only 7 cases reported. The occurrence of ectopic HM is also rare, with 26 fully documented tubal cases. We are not aware of any reported cases of ectopic HM in a postmenopausal patient. In a 51-year-old patient with 3 years amenorrhea, surgery revealed a necrotic, hemorrhagic mass involving the right peritubal space. Microscopically, chorionic villi were seen within the hemorrhagic mass accompanied by circumferential trophoblast hyperplasia. Immunohistochemically, p57(kip2) positive nuclei were prominent in the extravillous (intermediate) trophoblast. The HER2 FISH expression was diploid, consistent with the diagnosis of an early complete HM.

Complete hydatidiform mole in a 52-year-old postmenopausal woman: A case report and literature review

“…reviewed 38 cases of GTD in women aged 50 years or more, of whom 19 had invasive moles, five were HM patients, 12 were choriocarcinomas patients, and two had placenta-site trophoblastic disease [ 9 ]. There are about 14 cases [ 3 , 7 , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] ] in the global literature concerning CHM in the postmenopausal period ( Table 1 ). Based on these cases, the most common symptoms of CHM in postmenopausal women are vaginal bleeding (approximately 80%), uterine enlargement (100%), abdominal pain (42%), and nausea and vomiting (25%), as well as markedly elevated serum β-HCG levels.…”