Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO.
Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment. Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission. Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.
De Vos
M
M
Department of Gynaecology, Academic Hospital, Brussels Free University - (VUB), UZ Brussel, 1090 Brussels, Belgium.
Leunen
M
M
Fontaine
C
C
De Sutter
Ph
P
N Engl J Med. 1996 Dec 5;335(23):1740-8
8929267
Br J Obstet Gynaecol. 1994 Jul;101(7):637-8
8043548
Lancet Oncol. 2003 Nov;4(11):670-8
14602247
Best Pract Res Clin Obstet Gynaecol. 2003 Dec;17(6):893-903
14614888
Gynecol Oncol. 2000 Sep;78(3 Pt 1):309-12
10985885
Am J Obstet Gynecol. 1988 Jun;158(6 Pt 1):1299-306
3381858