Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review

Wu, Yan; Jiang, Guo‐Qing; Jin, Ying; Hao, Zengping

doi:10.1515/med-2021-0315

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…If untreated, GTD-induced hyperthyroidism can lead to life-threatening clinical consequences, therefore requiring early detection and treatment. Few cases of GTD and severe hyperthyroidism have been reported in perimenopausal women [5][6][7][8]. Here we report a case of an invasive hydatidiform mole in a perimenopausal woman with severe hyperthyroidism.…”

Section: Introductionmentioning

confidence: 79%

“…Until the present date, only four cases of hydatidiform mole and severe hyperthyroidism in perimenopausal women aged from 48 to 53 years have been reported over the available literature [5][6][7][8]. Among these cases, its manifestations ranged from severe clinical hyperthyroidism to thyroid storm, associated with markedly elevated levels of β-hCG.…”

Section: Discussionmentioning

confidence: 99%

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Severe Hyperthyroidism and Complete Hydatidiform Mole in Perimenopausal Woman: Case Report and Literature Review

Santos¹,

Monteiro²,

Pereira³

et al. 2022

Cureus

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Gestational trophoblastic disease (GTD) represents a heterogeneous group of disorders within placental trophoblastic cells that are rather rare in perimenopausal ages. One of its complications is the development of secondary clinical hyperthyroidism, which can be potentially complicated if not properly and early recognized. We report the case of a 50-year-old perimenopausal woman, gravida 2 para 2, who presented to the emergency department with severe acute lower abdominal pain and abnormal uterine bleeding for one month. She also reported abnormal sweating and palpitation for a one-week duration and amenorrhea for the previous three months. Abdominal examination showed a pelvic mass resembling a 15-week sized uterus. Serum β-hCG levels were strongly increased, and abdomen ultrasound displayed an enlarged uterus with "snow-storm" features, compatible with the diagnosis of GTD. Laboratory data revealed suppressed TSH levels and high free thyroxine and free triiodothyronine levels (4 and 1.5 times above the upper limit of normality, respectively). Thyrotropin-receptor antibodies (TRAb) levels were negative, and thyroid ultrasound excluded major structural disease. She was managed with anti-thyroid drugs, Lugol's iodine, beta-blockers, and steroids during preoperative care. Thereafter, she underwent surgery, being diagnosed with a hydatidiform mole postoperatively. Her thyroid function returned to normal after three months, without the further need for antithyroid drugs. This case highlights the importance of considering GTD as an aetiology for thyrotoxicosis in perimenopausal women, especially in the absence of findings suggesting primary thyroid disease.

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Section: Introductionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Severe Hyperthyroidism and Complete Hydatidiform Mole in Perimenopausal Woman: Case Report and Literature Review

Santos¹,

Monteiro²,

Pereira³

et al. 2022

Cureus

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“…Seven other cases of giant GTD are found in the literature all occurring in peri- or postmenopausal women [ 18 – 24 ]. They are all found in peri- or postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Giant complete hydatidiform mole: a case report and review of the literature

Bonomo,

Fopa,

Van Vinckenroy

et al. 2024

J Med Case Reports

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Background This case describes the youngest patient documented in the literature who presented with a giant hydatidiform mole, effectively addressed through conservative treatment. Case presentation Our department received a 20-year-old Caucasian patient who was admitted due to significant metrorrhagia in an undisclosed pregnancy. During examination, we identified a massive, highly vascularized hydatidiform mole measuring 22 cm (cm). We performed a surgical dilatation and curettage. The anatomopathological findings confirmed the presence of a complete hydatidiform mole (CHM). Following the established guidelines, we conducted weekly monitoring of human chorionic gonadotropin (hCG). Unfortunately, the patient discontinued the follow-up and became pregnant again before achieving hCG negativation. Conclusion This case suggests that conservative treatment is a viable option regardless of the size of gestational trophoblastic disease (GTD), especially when the preservation of fertility is a crucial consideration, as effectively demonstrated in our case.

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Multiple drugs

2021

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Multiple drugs Lack of efficacy: case reportA 48-year-old woman exhibited lack of effectiveness during treatment with nifedipine, furosemide, albumin human and plasma for preeclampsia and thiamazole for hyperthyroidism due to complication of perimenopausal giant hydatidiform mole [not all dosages stated; routes not stated].The woman (G6P4) was admitted due to vaginal bleeding for more than one month. Prior to admission, she had experienced intermittent nausea, increased abdominal circumference, dizziness, oedema, weight gain, poor diet and sleep. After admission, further to extensive investigation the initial diagnosis was hydatidiform mole complicated with hyperthyroidism and preeclampsia. She received nifedipine 10mg three times daily, furosemide 20mg once daily, albumin human [albumin] 10g once daily supplementation and plasma infusion 200mL for preeclampsia and thiamazole [methimazole] 10mg twice daily for hyperthyroidism; however, no remission of symptom was observed and oedema aggravated.The woman then underwent a total hysterectomy and bilateral adnexectomy. After the surgery, she was transferred to the ICU. On the first day after surgery, the serum HCG was increased and normal BP was noted on the third day after surgery. On the postoperative day 11, normal thyroid function was noted and oedema was also further reduced. Histopathological examination showed a complete hydatidiform mole. Her serum HCG level also decreased at the postoperative day 42. Chest CT scan revealed bilateral multiple lung nodules at about two months after the surgery. A diagnosis of gestational trophoblastic disease confirmed as invasive hydatidiform mole. She received therapy with fluorouracil [5-fluorouracil] and dactinomycin [actinomycin-D]. After one course of therapy, normal serum HCG level was noted suggesting that the invasive hydatidiform mole was sensitive to chemotherapy. She further received three courses of consolidation chemotherapy. During the last follow-up in November 2020, she recovered well and showed no abnormal lesions on imaging studies.

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Perimenopausal giant hydatidiform mole complicated with preeclampsia and hyperthyroidism: A case report and literature review

Cited by 4 publications

References 13 publications

Severe Hyperthyroidism and Complete Hydatidiform Mole in Perimenopausal Woman: Case Report and Literature Review

Severe Hyperthyroidism and Complete Hydatidiform Mole in Perimenopausal Woman: Case Report and Literature Review

Giant complete hydatidiform mole: a case report and review of the literature

Multiple drugs

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