Abstract :
Gestational trophoblastic neoplasia (GTN) comprises a spectrum of malignant trophoblastic disorders that may arise following any gestational event. Although uncommon, these lesions respond well to chemotherapy when detected early; however, they can present significant diagnostic challenges, especially in perimenopausal women.We report a case of a 49-year-old multiparous woman presenting with prolonged vaginal bleeding and severe anemia. She had a history of a spontaneous abortion that was managed conservatively one year prior. Serum ?-hCG was markedly elevated at 325,000 mIU/mL. Transvaginal ultrasound revealed a heterogeneous, vascular intrauterine lesion with cystic spaces suggesting an invasive mole. MRI confirmed myometrial invasion without serosal breach or distant metastasis. Based on clinical, laboratory, and imaging criteria, a diagnosis of low-risk GTN was made. The patient responded well to single-agent chemotherapy with normalization of ?-hCG levels. This case underscores the importance of considering GTN in perimenopausal women with abnormal bleeding and elevated ?-hCG. Early detection, guided by clinical suspicion and supported by imaging and tumor markers, is crucial for effective treatment. Chemotherapy remains the cornerstone of management with favorable prognosis in low-risk cases.
Keyword :
Gestational trophoblastic neoplasia, Invasive mole, Trophoblastic, ?-hCG, Dynamic MRI, Gestational trophoblastic disease.