Molar pregnancy has always been of interest to physicians because of t
he diagnostic and management challenges it presents. Its occurrence in
patients older than 50 years of age is rare and misdiagnosis is commo
n. A 51 year old black female presented to the gynecology emergency ro
om with vaginal bleeding for twenty days. She was diagnosed with a mol
ar pregnancy by a pelvic ultra-sound. Prior to presenting to the emerg
ency room she had a negative work-up for hyperthyroidism, including a
biopsy of a benign thyroid nodule and was also started on Inderal for
new onset hypertension. She underwent a primary hysterectomy and subse
quently required five courses of actinomycin D for plateauing of the B
hCG. The different forms of presentation of gestational trophoblastic
disease should be kept in mind so that the diagnosis can be made promp
tly and appropriate treatment started early, especially in patients wi
th advanced age.