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Ginecología y obstetricia de México
versão impressa ISSN 0300-9041
Resumo
HERNANDEZ-ALBINO, Maira Fernanda e PADRON-ARREDONDO, Guillermo. Complete hydatidiform mole in a perimenopausal woman. Clinical case. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.5, pp.377-381. Epub 01-Set-2023. ISSN 0300-9041. https://doi.org/10.24245/gom.v91i5.8077.
BACKGROUND:
Hydatidiform mole is divided into complete and partial. The former originates from fertilization of an anucleate ovum by two spermatozoa with independent genetic load and the predominant clinical manifestation is hemorrhage. The uterine size is usually larger than normal, with subjective symptoms of pregnancy. The importance of this type of tumor is its premalignant character that can evolve into a trophoblastic neoplasm, so that in the complete mole it will transform into a neoplasm.
CLINICAL CASE:
43-year-old patient who came for consultation due to the fall of her support plane 3 days earlier, with pelvic pain in the hypogastrium, cramping of moderate intensity, without transvaginal bleeding. She reported being pregnant, without remembering the date of her last menstrual period; no prenatal check-up or previous ultrasound. On physical examination the abdomen was found to be globose, at the expense of a hypertrophic uterus measuring 16 x 12 x 10 cm, HGCß concentrations greater than 150,000 mIU/mL. Endovaginal and pelvic ultrasound reported: anteverted, central, enlarged uterus with snowflake-shaped ultrasound image. Diagnosis: hydatidiform mole. Abdominal hysterectomy was indicated, with findings of an enlarged uterus at the expense of complete mole and unaltered adnexa.
CONCLUSION:
The patient's diagnosis was fortuitous, noticed on ultrasound. The therapeutic approach established for this type of case in older patients with satisfactory parity allowed for a satisfactory evolution and continued follow-up.
Palavras-chave : Molar pregnancy; Gestational trophoblastic disease; Hydatidiform mole.