GESTATIONAL TROPHOBLASTIC DISEASE FOLLOWING THE EVACUATION OF PARTIALHYDATIDIFORM MOLE - A REVIEW OF 66 CASES

Objective: The current study was undertaken in order to identify the c linical characteristics and natural history, as well as methods of inv estigation and available therapy, of persistent gestational trophoblas tic disease (GTD) following the evacuation of partial hydatidiform mol e (PM). Methods: Case reports of persistent GTD following the evacuati on of partial mole, were searched using the Medline computerized retri eval system. There were 66 such cases (including 4 cases treated at ou r department), representing 2.9% of GTD following PM. Results: The mea n age of the women at diagnosis was 28.4 years and mean gravidity was 2.99. The mean gestational age at diagnosis was 15.5 weeks and the mea n uterine size was 13.6 weeks. The most common presenting symptom was vaginal bleeding. In the majority of the patients, the pre-evacuation diagnosis was incomplete or missed abortion. Conclusions: Although the malignant potential of PM is low, persistent GTD may develop after PM and may even metastasize, it is usually responsive to single agent ch emotherapy but may require combination chemotherapy. Therefore, after evacuation of PM, these women should be followed with serial serum b-h CG. Further research is needed to enable earlier identification of PM that eventually will develop persistent GTD. Copyright (C) 1997 Elsevi er Science Ireland Ltd.