Gestational trophoblastic disease with unusually high levels of hCG: A case report

The reported incidence of gestational trophoblastic disease is 1-2:1000 pregnancies. The disease includes a) hydatidiform mole (partial and complete), b) invasive mole, c) choriocarcinoma and d) placental site trophoblastic tumors. Current management is based on several prognostic risk factors. We describe an interesting case of a 51-year–old woman who presented with abnormal vaginal bleeding and an uterine size approximately 20 weeks of gestational age. Ultrasonography revealed a mole pregnancy and serum hCG was 1.682.718mIU/ml. There was no obvious metastatic disease at the time of diagnosis. The patient underwent 8 courses of combined chemotherapy and then an abdominal hysterectomy was performed. We discuss the individualized management options of trophoblastic disease based on the extremely high levels of hCG and the other prognostic factors.