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Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo

Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1010-1017页

作者： Julien Bwama De-Joseph Kakisingi Mibi Nsenga Bin Musa Jeff Andrea Mbozi Déborah Kambonesa Salire Dieudonné Kakusu christine amisi tina Aroni Toto Tchass Chasinga Baharanyi Denis Mukwege Mukengere Olivier Nyakio Ngeleza Department of Gynaecology-Obstetrics Faculty of Medicine and Community Health Evangelical University in Africa Bukavu Democratic Republic of Congo Gynaecology-Obstetrics Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Saint Vincent Hospital Bukavu Democratic Republic of Congo Medical Imaging Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Anatomopathology Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Panzi Foundation Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine Official University of Bukavu Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine University of Kindu Kindu Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

关键词： Complete Hydatidiform Mole Menopause β-HCG Panzi Bukavu DRC

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