|
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.
|