title: A HELLP syndrome complicates a gestational trophoblastic neoplasia in a perimenopausal woman: a case report.
abstract: HELLP syndrome is a combination of symptoms described as hemolysis, elevated liver enzymes and low platelets, that complicates 0.01-0.6 % of pregnancies. HELLP syndrome has been scarcely reported associated with partial moles, another rare complication of pregnancy. This manuscript describes the only reported case of HELLP syndrome associated with a complete invasive hydatiform mole.
  
  
  
  We report a perimenopausal patient in prolonged remission from an uncommon high-risk invasive complete mole. The diagnosis was set in a context of early onset preeclampsia and HELLP syndrome. The development of life-threatening complications required primary hysterectomy. Postoperative hCG quickly returned to normal with EMA/CO multi-agent chemotherapy.
  
  
  
  Our patient is in prolonged remission from a complete mole complicated with EOP and HELLP syndrome. This exceptional case of complicated gestational trophoblastic neoplasia reflects a very rare condition in which several risk factors for placental ischemia are associated. Emergency hysterectomy should be considered as salvage initial treatment in such life-threatening situations.
authors.affiliation: Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54500, Vandoeuvre Les Nancy, France. g.vogin@nancy.unicancer.fr.
authors.forename: Guillaume
authors.identifier: 0000-0002-8114-5900
authors.initials: G
authors.lastname: Vogin
authors.affiliation: Department of Obstetrics and Gynaecology, Lyon Sud University Hospital, Lyon, France.|French Trophoblastic Disease Reference Centre, Lyon Sud University Hospital, Lyon, France.
authors.forename: François
authors.initials: F
authors.lastname: Golfier
authors.affiliation: French Trophoblastic Disease Reference Centre, Lyon Sud University Hospital, Lyon, France.
authors.forename: Touria
authors.initials: T
authors.lastname: Hajri
authors.affiliation: Department of Pathology, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Leroux
authors.affiliation: Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Avenue de Bourgogne, 54500, Vandoeuvre Les Nancy, France.|Department of Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Weber
mesh_terms: D005260:Female; D031901:Gestational Trophoblastic Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D017359:HELLP Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D047648:Perimenopause; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Gestational trophoblastic neoplasia; HELLP syndrome; Perimenopause; Preeclampsia