Boring form of an invasive mole: case report and review of the literature

Abstract

Gestational trophoblastic diseases include a heterogeneous group of pathologies due to abnormal trophoblast proliferation. These diseases are rare and most often have a good prognosis. Management recommendations are based mainly on expert opinions, such as those published in 2020 by the European Organisation for the Treatment of Trophoblastic Disease (EOTTD). They have a common name, but their origins, clinical characteristics and treatment differ. Hydatidiform moles correspond to villi with an excess of paternal genetic material and having a malignant potential, higher for complete Hydatidiform moles than for partial Hydatidiform moles Invasive mole is responsible for most cases of localized gestational trophoblastic neoplasia, occurring during pregnancy, within a variable period, but in most cases it is diagnosed after a molar pregnancy. Histological proof is sometimes difficult on curettage product, and must then take into account imaging and serum hCG levels. The overall cure rate is nearly 100% in low-risk patients and 90% in high-risk patients, since the advent of chemotherapy. In rare cases, the molar tissue crosses the thickness of the myometrium, the serosa and leads to hemoperitoneum associated with an acute abdomen as well as metastases, which is infrequently encountered in the invasive mole. The best course of treatment is chemotherapy (depending on the stage and the score with mono or poly chemotherapy) and in patients whose fertility is not in question, a hysterectomy can be performed. On the occasion of a clinical case, we will expose a dissecting form with an ovarian metastasis of an invasive mole. The treatment was successful. During the follow-up, she remained free of the disease without any sequelae.