Tasneem Ashraf.
Invasive metastatic mole with vaginal metastasis.
Pak J Med Res Jan ;43(2):90-1.

A case of 18 years old second gravida with invasive Hydatidiform mole is presented. There are few peculiar facts about this case. Firstly, though there was complain of persistent vaginal bleeding following two months amenorrhoea there was no history of expulsion of molar tissue. Secondly there was difficulty and delay in diagnosis due to unskilled ultrasonologist and neglect by a senior doctor by prescribing medicines after reading u/s report without examining the patient herself. Later on local examination showed sub urethral nodule and positive pregnancy test pointed towards trophoblastic disease but the site of primary lesion was not clear. Therefore laparotomy, diagnostic curettage and nodule biopsy was done. Eventually histo-pathological examination confirmed the diagnosis. Thirdly, though it was an invasive mole with vaginal metastasis, it regressed spontaneously without any chemotherapy. In 8 month follow up she is asymptomatic and healthy.

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