Case Report Complete hydatidiform mole with massive intrauterine hemorrhage in an adolescent girl

Hydatidiform mole (HM) is a premalignant proliferative trophoblastic disorder. Vaginal bleeding is the most common presenting symptom in women with HM. A 17-year-old nulliparous adolescent girl presented with progressive lower abdominal pain and pronounced nausea and vomiting of about a week’s duration. Her gestational age was 12 weeks and 4 days according to her last menstruation date. Pelvic examination revealed a closed cervical os and no uterine bleeding. Subsequent ultrasound and magnetic resonance imaging (MRI) depicted a T2hyperintense, huge intrauterine mass, numerous cystic spaces, and massive peri-lesional hemorrhage. Immediately after introducing a forcep into the uterine cavity for suction curettage, a large amount of trophoblastic tissue was expelled and sudden gushes of blood with clots were passed. Histological examination and p57 immunohistochemistry resulted in a final diagnosis of complete hydatidiform mole. Massive intrauterine concealed hemorrhage in an adolescent is a rare complication of complete hydatidiform mole.