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.