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Hydatidiform mole

Case contributed by Chris Newman
Diagnosis almost certain

Presentation

G2P1. Previous inconclusive scan at 5 weeks gestation presents with hyperemesis. ? viability.

Patient Data

Age: 40 years
Gender: Female
ultrasound
  • distended uterine cavity by an enlarged heterogenous placenta showing multi-cystic 'bunch of grapes' appearance
  • small volume anechoic fluid, which may represent either an irregular empty gestational sac, which is being compressed and displaced by the heterogenous mass or simple fluid within the cavity
  • no definite fetal parts
  • the mass demonstrates increased vascularity on Doppler assessment
  • no myometrial invasion
  • right ovarian corpus luteum
  • no pelvic free fluid

Case Discussion

Hydatidiform moles are within the spectrum of gestational trophoblastic disease, which results in abnormal proliferation of trophoblastic tissue.

This patient's beta HCG was very high relative to the expected conception date.

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