GESTATIONAL TROPHOBLASTIC DISEASE IN A 51 YEAR-OLD WOMAN

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.