PDF(Pubmed)
Abstract：
Invasive mole (IM) is a very uncommon subtype of gestational trophoblastic disease (GTD), which is the invasion of molar tissue into the uterine or myometrial vasculature. However, this report presents a rare case of a 41-year-old female multiparous P7 with five full-term normal vaginal deliveries and two preterm normal vaginal deliveries. As the patient was not using contraception, her urine pregnancy test (UPT) was done, which demonstrated positive results. A speculum examination revealed a healthy cervix with just mild bleeding, whereas a vaginal examination revealed a firm cervix and an anteverted and mobile eight-week-old uterus along with a free fornix. Pelvic ultrasound and magnetic resonance imaging (MRI) demonstrated the diagnosis of GTD, for which consultation from an oncology physician was taken and the treatment proceeded with a total abdominal hysterectomy. Histological examination of the uterus showed a circumscribed nodule showing a large area of hemorrhage with few chorionic villi lined with trophoblastic cells and occasional villi invading the myometrium and endometrial cavity suggesting hydatidiform mole showing early invasion that confirmed the diagnosis of IM. In conclusion, reproductive-age women who experience abnormal uterine bleeding (AUB) should suspect pregnancy with several possible complications, for which a pregnancy test should be done to rule out complications.
摘要：
侵袭性葡萄胎（IM）是妊娠滋养细胞疾病（GTD）的一种非常罕见的亚型，这是磨牙组织侵入子宫或肌层脉管系统。然而,本报告提供一例41岁女性经胎P7罕见病例,其中5例足月正常阴道分娩和2例早产正常阴道分娩.由于病人没有使用避孕药，她的尿妊娠试验(UPT)完成了，这证明了积极的结果。窥器检查显示子宫颈健康，只有轻度出血，而阴道检查显示子宫颈坚固，8周大的前弯曲且可移动的子宫以及游离的穹窿。盆腔超声和磁共振成像（MRI）证明了GTD的诊断，为此，我们接受了肿瘤科医生的咨询，并进行了全腹子宫切除术。子宫的组织学检查显示有一个孤立的结节，显示出大面积的出血，很少的绒毛膜绒毛衬有滋养细胞，偶尔有绒毛侵入子宫肌层和子宫内膜腔，提示葡萄胎显示出早期侵袭，证实了IM的诊断。总之,经历异常子宫出血（AUB）的育龄女性应该怀疑怀孕有几种可能的并发症，应进行妊娠试验以排除并发症。
