This is a molar pregnancy which keeps on coming back. It is usually seen in teenagers and women older than 40. The condition can be benign or malignant (cancerous). There is history of absence of menstruation (amenorrhea) or abnormal duration of menstruation. Sometimes there is passage of the typical hydatid vesicles through the vaginal opening. if the condition has already spread to other organs additional symptoms can be felt depending on the area of metastases. There can be abdominal pain, blood in the urine, or coughing out of blood. The most common areas of spread are the brain, lungs, kidneys, gastrointestinal tract, and the lower genital tract. After evacuation of the tissue from the uterus it is sent to the laboratory for histopathologic examination. There is no accurate method to predict the behavior of the hydatidiform mole. The only monitoring done is the serum HCG level. In big percentage of cases the condition is benign and the serum HCG level decreases to normal level in 2 to 3 months. A very small percentage of benign cases develop into malignancy. There is no need for therapy in benign cases. The patient is advised to use a reliable method of contraception and the serum HCG level is still monitored weekly to monitor development. In some individuals methotrexate is given as prophylaxis for malignancy. In malignant cases, the serum HCG can go beyond 100,000mlU/ml. This is usually treated with chemotherapy. It is also important to rule out metastasis to other organs hence liver function tests, chest x-ray, and CT scan of head and abdomen are requested. |
