title: Complete hydatidiform mole coexisting with a twin live fetus: clinical course.
abstract: A 33-year-old G4P0 white female presented for a pregnancy ultrasound at 9 weeks gestation and was found to have a complete hydatidiform mole coexisting with a live twin fetus (CHTF). The beta-hCG level was 600,000 mIU/ml and the chest X ray was negative. The pregnancy was uneventfully terminated by suction curettage and oral contraceptives were prescribed. The initial beta-hCG declined appropriately; however, it subsequently rose. The metastatic workup was negative and the patient was treated with weekly intramuscular methotrexate at 30 mg/m2. The hCG levels declined appropriately and then plateaued. Salvage chemotherapy with intravenous actinomycin D at 1.25 mg/m2 every 14 days was started. The hCG level normalized after 3 cycles and the patient was free of disease at 1 year follow-up.
authors.affiliation: Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis 46202-5274, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Hurteau
authors.forename: L M
authors.initials: LM
authors.lastname: Roth
authors.forename: J M
authors.initials: JM
authors.lastname: Schilder
authors.forename: J
authors.initials: J
authors.lastname: Sumners
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D003609:Dactinomycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000188:drug therapy / Q000473:pathology*; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011272:Pregnancy, Multiple; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D003609:Dactinomycin; D008727:Methotrexate