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| Tubal Molar Pregnancy: A Case Report and Literature Review |
F.Ouakka, A Elmoctar, M.K.Saoud, N.Mamouni, S.Errarhay, C.Bouchikhi and A.Banani
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Abstract:
Gestational trophoblastic diseases (GTDs) constitue a spectrum of tumors characterizied by abnormal proliferation of pregnancy associated trophoblastic tissue with progressive malignant potential. GTD is classified into premalignant disease, termed complete and partial hydatiform mole (CM, PM), and malignant disorders (invasive mole, placental site trophoblastic tumor and choriocarcinoma)[1]. In most instances, moles develop within the uterine cavity, but may occur at any site. Ectopic molar pregnancy is a rare event, the first report on tubal mole was published in 1872 by Otto[2]. The incidence of ectopic hydatiform mole was found to be 1 per 1,000.000 pregnancies [3]. It's a rarity and less than 50 cases have been reported in the literature[4]. Patients with tubal molar pregnancy are very difficult to distinguish from patients with non-molar tubal pregnancy by means of presenting signs, symptoms or laboratory test[5]. Human chorionic (HCG) level is elevated in molar intrauterine pregnancies, but found to be in lower range in tubal molar pregnancy because implantation in the fallopian tube precludes adequate vascularization, and therefore may not be a good marker to diagnose this condition[6]. Accurate histopathology assessement of such cases remains the most reliable method of diagnosing these cases[7]. Management of ectopic molar gestation includes immediate removal of conceptus either via laparotomy or laparoscopically, followed by histological evaluation of the specimen and follow-up using serial hCG measurements similar to other trophoblastic tumors[2]. The outcome of the treatement of these patients is similar to those coming with non-molar ectopic gestation. We report a rare condition of ruptured tubal molar pregnancy.
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