Abstract
Ectopic molar pregnancy is extremely rare, and preoperative diagnosis is difficult. Our literature search found only one report of molar pregnancy diagnosed preoperatively. Moreover, there is no English literature depicting magnetic resonance image (MRI) findings of ectopic molar pregnancy. We report a case of ectopic molar pregnancy preoperatively diagnosed using MRI. A literature review of 31 cases of ectopic molar pregnancy demonstrated that lesions have been found in the fallopian tube (19 cases, 61%), ovary (5 cases, 16%), cornu (3 cases, 10%), peritoneum (2 cases, 6%), uterine cervix (1 case, 3%), and cesarean scar (1 case, 3%). Abdominal pain and abnormal vaginal bleeding were reported in 70% and 61% of the patients, respectively. Twenty-one cases (67%) presented with rupture and hemoperitoneum. All patients underwent surgical resection or dilatation and curettage. Methotrexate therapy was performed in one case because residual trophoblastic tissue was suspected. A second operation was performed in one case of ovarian molar pregnancy because serum hCG levels increased again after primary focal ovarian resection. No patients developed metastatic disease or relapsed. These findings suggest the prognosis of ectopic molar pregnancy to be favorable.
Highlights
Gestational trophoblastic disease (GTD) consists of hydatidiform mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor
Preoperative diagnosis of ectopic molar pregnancy is difficult, and we found only one reported case
We suspected cornual molar pregnancy because transvaginal ultrasonography revealed a mass with small vesicles in the right cornu, which is a typical finding of molar pregnancy
Summary
Gestational trophoblastic disease (GTD) consists of hydatidiform mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Because the majority of GTD cases occur in the uterus, ectopic molar pregnancy is extremely rare. Gillespie et al estimated that the incidence of ectopic GTD is 1.5 per one million births in the UK [1]. Preoperative diagnosis of ectopic molar pregnancy is difficult, and our literature search found only one report of molar pregnancy diagnosed preoperatively [2]. There is no English literature depicting magnetic resonance image (MRI) findings of ectopic molar pregnancy. We report the first case of ectopic molar pregnancy preoperatively diagnosed using MRI, with a review of the literature
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