Self-Assessment Questions

45. Genetic imprinting and reproductive tract tumors

• A 42-year-old woman comes in to the emergency department with vaginal bleeding, as well as severe nausea and vomiting. She reports that she recently had a positive pregnancy test. You order a β-hCG level and perform an ultrasound. The imaging you perform suggests of a complete molar pregnancy. Describe the β-hCG lab result that you would expect given your diagnosis, and what treatment options could you offer the patient?

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  Correct answer:
  With a complete hydatidiform mole, one would expect to find markedly elevated β-hCG levels. If the patient does not desire to maintain fertility, a hysterectomy could be offered as treatment. Otherwise, an evacuation of the molar tissue from the uterine cavity could be performed. If her disease persists despite evacuation, chemotherapeutic agents such as methotrexate can be offered.