title: Bilateral adnexal torsion due to postmenopausal hydatidiform mole.
abstract: Occurrence of gestational trophoblastic neoplasia (GTN) and adnexal torsion is rare in postmenopause. We report a 58-year-old postmenopausal woman with adnexal torsion caused by hydatidiform mole. The patient was admitted to our clinic complaining of acute abdominal pain, nausea and vomiting lasting one day. Ultrasonography showed an enlarged uterus including hypo/hyperechogenous cystic areas in the endometrial cavity and bilateral adnexal masses. β-HCG level was investigated and determined as 157.000 IU/l, because of the suspicion of GTN in ultrasonography. Doppler sonography revealed enlarged left adnexa with absence of vascular flow. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. β-HCG decreased to normal ranges in the fourth postoperative week. The resected uterus contained an endometrial, cystic, grapelike tumor. The ovaries were enlarged bilaterally with necrotic appearance. Histopathology revealed complete hydatidiform mole and theca lutein cysts. To our knowledge, the present case is the first hydatidiform mole associated with bilateral adnexal torsion caused by theca lutein cysts in postmenopausal period.
authors.affiliation: Department of Obstetrics and Gynecology, Selçuk University, Meram Medical Faculty, Konya, Turkey. snmstf@yahoo.com
authors.forename: Suna
authors.initials: S
authors.lastname: Özdemir
authors.forename: Osman
authors.initials: O
authors.lastname: Balcı
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Görkemli
authors.forename: Tuba
authors.initials: T
authors.lastname: Koyuncu
authors.forename: Gülay
authors.initials: G
authors.lastname: Turan
mesh_terms: D000291:Adnexal Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000503:physiopathology*; D008875:Middle Aged; D017698:Postmenopause; D011247:Pregnancy; D014102:Torsion Abnormality / Q000209:etiology*