Complete hydatidiform mole with bilateral theca lutein cysts

Case contributed by Kewal Arunkumar Mistry
Diagnosis almost certain

Presentation

Patient with amenorrhea of 12 weeks presented with bleeding per vaginum.

Patient Data

Age: 20 years
Gender: Female

The uterus is enlarged with hypodense, heterogeneously enhancing contents causing distension of the uterine cavity. Both ovaries are enlarged and contain multiple cysts.

Transabdominal

ultrasound

The uterus is markedly enlarged with presence of echogenic contents and multiple small cystic areas within the uterine cavity. Both ovaries are enlarged and show multiple cysts within them with few showing fluid debris levels likely due to hemorrhage within the cysts.

Case Discussion

Undiluted urine pregnancy test was negative which is likely due to the pro-zone phenomenon (due to very high urinary beta hCG). US was suggestive of complete hydatidiform mole with theca lutein cyst. Subsequently, abdominal and thoracic CT scan was done which revealed no metastasis or obvious extrauterine extension.

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