Gestational trophoblastic disease following the evacuation of partial hydatidiform mole: a review of 66 cases.
OBJECTIVE
The current study was undertaken in order to identify the clinical characteristics and natural history, as well as methods of investigation and available therapy, of persistent gestational trophoblastic disease (GTD) following the evacuation of partial hydatidiform mole (PM).


METHODS
Case reports of persistent GTD following the evacuation of partial mole, were searched using the Medline computerized retrieval system. There were 66 such cases (including 4 cases treated at our department), representing 2.9% of GTD following PM.


RESULTS
The mean age of the women at diagnosis was 28.4 years and mean gravidity was 2.99. The mean gestational age at diagnosis was 15.5 weeks and the mean uterine size was 13.6 weeks. The most common presenting symptom was vaginal bleeding. In the majority of the patients, the pre-evacuation diagnosis was incomplete or missed abortion.


CONCLUSIONS
Although the malignant potential of PM is low, persistent GTD may develop after PM and may even metastasize, it is usually responsive to single agent chemotherapy but may require combination chemotherapy. Therefore, after evacuation of PM, these women should be followed with serial serum b-hCG. Further research is needed to enable earlier identification of PM that eventually will develop persistent GTD.
Zalel
Y
Y
Department of Obstetrics and Gynecology, Kaplan Hospital (Affiliated to the Medical School of the Hebrew University and Hadassah, Jerusalem), Rehovot, Israel.
Dgani
R
R
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006063:Chorionic Gonadotropin / Q000097:blood; D003609:Dactinomycin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications* / Q000235:genetics / Q000601:surgery; D007044:Hysterectomy; D007621:Karyotyping; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D014328:Trophoblastic Neoplasms / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D014594:Uterine Neoplasms / Q000209:etiology* / Q000235:genetics / Q000628:therapy
D006063:Chorionic Gonadotropin; D003609:Dactinomycin; D002955:Leucovorin; D008727:Methotrexate