Journal List > Korean J Obstet Gynecol > v.55(10) > 1088534

Moon, Kim, Moon, Kang, and Choi: METASTATIC GESTATIONAL TROPHOBLASTIC NEOPLASM PRESENTING AS SPONTANEOUS RENAL AND CEREBRAL HEMORRHAGE WITH LOW TITER OF HCG: A CASE REPORT OF AN UNUSUAL CASE

Abstract

Gestational trophoblastic neoplasm includes tumor spectrum of four entities: hydatidiform mole (complete and partial), invasive mole, choriocarcinoma and placental site trophoblastic tumor. The hydatidiform mole is usually benign, but it is regarded as a pre-malignant disease. The other three conditions are malignant and are termed gestational trophoblastic tumor. Although most molar pregnancies behave in a benign fashion, metastatic tumors develop after complete molar pregnancy in 4% of patients. However, even when the disease is spread to many distal organs, it is highly curable with chemotherapy in most cases. We recently encountered an unusual case of metastatic gestational trophoblastic neoplasm following complete mole, presenting as spontaneous renal and cerebral hemorrhage with a fatal course.

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Fig. 1.
Microscopic examination of the evacuated molar tissue. Enlarged villous with central cavitation and surrounding trophoplastic hyperplasia are shown. Complete mole was diagnosed (H&E, ×100).
kjog-55-766f1.tif
Fig. 2.
Abdominopelvic computed tomography showing renal hemorrhage with multiple metastases.
kjog-55-766f2.tif
Fig. 3.
Brain computed tomography showing acute intracranial hemorrhage in the left frontal lobe.
kjog-55-766f3.tif
Fig. 4.
(A) Macroscopic finding of metastatic lesion in the brain and (B) Microscopic examination of the removed tumoral bleeding from the brain (H&E, ×200). Metastatic invasive mole was diagnosed.
kjog-55-766f4.tif
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