The Rare Association of Ectopic Pregnancy and Hydatidiform Mole: A Case Report

Abstract

An ectopic molar pregnancy is a rare event, occurring in 1 in every 20,000–100,000 pregnancies. The condition may present as a complete or partial molar pregnancy and the ectopic site can vary as in a non-molar ectopic pregnancy. When a molar pregnancy presents as a tubal ectopic pregnancy, the risks related to both conditions, including tubal rupture and progress to malignancy, are compounded. The definitive diagnosis is normally reached by histopathology of the surgical specimen, since imaging tests are usually unable to differentiate between a molar and a non-molar ectopic pregnancy. While the specific histological findings may confirm the diagnosis of hydatidiform mole, immunohistochemistry is essential to differentiate between a complete and a partial molar pregnancy. Although in the majority of cases surgical resection is considered the definitive treatment, it is estimated that 20% of patients with a molar pregnancy may develop gestational trophoblastic neoplasia, hence requiring a risk-specific follow-up. This report describes a case of a tubal molar pregnancy and includes a review of clinical, diagnostic and therapeutic aspects, as well as a discussion on the particularities of this rare association.