Reddy Ravikanth
Radiodiagnosis, St. John's Hospital, Bengaluru, IND.
Cureus. 2021 Dec 7;13(12):e20245. doi: 10.7759/cureus.20245. eCollection 2021 Dec.
Gestational trophoblastic disease (GTD) comprises placental-site hydatidiform moles, invasive moles, or choriocarcinoma which are of unknown etiology and characterized by abnormal proliferation of gestational trophoblastic tissue. Furthermore, malignant GTD is also characterized by hematogenous spread to distant metastatic sites. Nevertheless, early diagnosis of gestational trophoblastic disease is important to ensure timely and successful management of the clinical condition and for the preservation of fertility. We report the unusual case of a complete hydatidiform mole to pulmonary metastases in a 27-year-old woman with elevated beta-human chorionic gonadotropin (β-hCG) levels. The placental histopathology showed a complete hydatidiform mole with absent fetal parts. Beta-human chorionic gonadotrophin (β-hCG) levels were found elevated at 893 mIU/mL. The case was discussed at the multidisciplinary tumour board and surgical resection with four cycles of combination chemotherapy was recommended, following which β-hCG normalization was achieved. This case report highlights the importance of clinical vigilance even in low-risk patients. Unexpected findings on ultrasound should involve multidisciplinary input from radiologists and surgical oncologists. A high index of suspicion for gestational trophoblastic disease and imaging follow-up for metastases is imperative.
妊娠滋养细胞疾病（GTD）包括胎盘部位葡萄胎、侵袭性葡萄胎或绒毛膜癌，其病因不明，特征为妊娠滋养细胞组织异常增殖。此外，恶性GTD的特征还包括经血行播散至远处转移部位。然而，妊娠滋养细胞疾病的早期诊断对于确保及时、成功地处理临床病情以及保留生育能力至关重要。我们报告了一例不寻常的病例，一名27岁β-人绒毛膜促性腺激素（β-hCG）水平升高的女性，完全性葡萄胎发生肺转移。胎盘组织病理学显示为完全性葡萄胎，未见胎儿部分。β-人绒毛膜促性腺激素（β-hCG）水平升高至893 mIU/mL。该病例在多学科肿瘤讨论会上进行了讨论，建议进行手术切除并联合四个周期的化疗，之后β-hCG恢复正常。本病例报告强调了即使在低风险患者中临床警惕性的重要性。超声检查中的意外发现应包括放射科医生和外科肿瘤学家的多学科意见。对妊娠滋养细胞疾病保持高度怀疑指数并对转移灶进行影像学随访至关重要。
