ABSTRACT
A 22-year-old Asian woman is admitted to the hospital with an incomplete miscarriage at 11 weeks’ gestation. An ultrasound shows a ‘snow storm’ appearance. She passes grape-like vesicles through the vagina. She subsequently has a surgical evacuation of the uterus. The histology reveals a large mass with hydropic changes in all the placental villi and no fetal tissue. She is followed up with serum beta human chorionic gonadotrophin (βhCG) levels. There was an initial fall but it started to rise gradually (10,000 units/mL) at 3 months’ follow up. Her CT scan chest, abdomen and pelvis are normal except localized thickened vascular area in the posterior wall of uterus. What is the likely diagnosis?
Gestational choriocarcinoma
Persistent trophoblastic disease
Non-invasive mole
Non-gestational choriocarcinoma
Placental site trophoblastic disease
