Fertility preserving treatment in a nulliparous with a molar pregnancy: a case report

Vol. 55 No. 2 Suppl., 2014
This supplement was not sponsored by Outside Organizations.


George Alexandru Filipescu, Andreea Gratiana Boiangiu, Nicoleta Clim, Florin Andrei

Hydatidiform mole represents an abnormal form of conception that occurs in about one in 500-1000 pregnancies. It is a subtype of gestational trophoblastic disease. Hydatidiform moles should be regarded as premalignant lesions because 15-20% of complete hydatidiform moles (CHMs) and 1% of partial hydatidiform moles (PHMs) undergo malignant transformation into invasive moles, choriocarcinomas, or, in rare cases, placental-site trophoblastic tumors (PSTTs). We will illustrate the case of a 26-year-old nulliparous with a seven weeks amenorrhea, positive immunological pregnancy test, a beta-HCG value of 136 000 mIU/mL and minor vaginal bleeding. The ultrasonographic examination showed an enlarged endometrium with adjacent hyperechoic material containing tiny anechoic spaces and an anembryonic pregnancy, distended endometrial cavity containing innumerable, variably sized anechoic cysts with intervening hyperechoic material (snowstorm appearance). The CT showed a uterine mass measuring 89/111/67 mm, inhomogeneous density, proliferative-infiltrative endocavitary tissue without exceeding the peritoneal serosa, and a few pulmonary micronodules with not certain origin on the left inferior lobe. In this case, due to the large infiltrative uterine mass, the risk of severe bleeding after curettage and the possibility of a necessity hysterectomy, we decided to apply first of all the Methotrexate protocol for molar pregnancy.

Corresponding author: George Alexandru Filipescu, MD, PhD; e-mail: afilipescu@hotmail.com

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Viorel Ibric-Cioranu, Vasile Nicolae, Daniel Iorgulescu, Iulian Mihai Fagetan, Vlad Petrescu Seceleanu, Mihaela Cernusca-Mitariu, Silviu Nicolae, Sorin Ibric-Cioranu

There is a wide variety of tumors affecting the orbit. The most encountered histological type of malignant orbital tumor is the basal cell carcinoma followed by the malignant melanoma and the squamous cell carcinoma. The authors conducted a retrospective review of the malignant orbit tumors from the Department of Oral and Maxillofacial Surgery, University Emergency Hospital of Sibiu, Romania. The main surgical methods implied were tumor resection, exenteration and extended exenteration. The reconstruction was performed with the help of local flaps using different techniques: advancement, translation or rotation. The use of local flaps allowed for a good esthetic outcome and a decrease in the healing time.

Corresponding author: Viorel Ibric-Cioranu, Professor, DMD, PhD; e-mail: maxfaxsurg@yahoo.com

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