VOLUME 4 - NUMBER 2-3 - 2022
High-risk metastatic post-molar neoplasia complicating twin pregnancy with complete mole and coexisting fetus. Case report and review of the literature
Marie Jacques, Frédéric Goffin, Anne-Céline Cheron, Julie Vanalbada, Jean-Louis Christophe, Dominique Carly, Brigitte Honhon, Luc Dewolf, Timour Willems
Case reports, 82-85
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Objective: To raise awareness of the recognition of twin pregnancy with complete hydatidiform mole and normal coexisting fetus (CHMCF). CHMCF are at high risk of developing preeclampsia, prematurity and up to 50% fetal loss. Additionally, about 35% develop gestational trophoblastic neoplasia, irrespectively of the duration of the pregnancy.
Case report: The patient was a primigravida with poorly controlled type 1 diabetes who became pregnant after ovulation stimulation and intrauterine insemination. She suffered from vaginal bleeding, hyperthyroidism and preeclampsia. CHMCF was suspected at 28 weeks of gestation. A caesarean section was performed at 30 weeks due to progressive high-risk diabetic retinopathy. The patient developed a high-risk metastatic post molar neoplasia with lung metastases and was treated with multidrug chemotherapy.
Conclusion: It is important to recognize early CHMCF to manage maternal and fetal complications, and inform patients about related risks and to allow them to decide about the continuation or termination of pregnancy.
KEY WORDS: Choriocarcinoma, diabetes mellitus, gestational trophoblastic neoplasia, hydatidiform mole, twin pregnancy.