Right Parametrial Gestational Trophoblastic Neoplasm Presenting as Right Tubal Ectopic - A Case Report

Abstract

Mrs Y, 39 years of age, was referred on 20/5/23 to our emergency as G₅P₂L₂A₂(2 previous LSCS for both live births) with severe pelvic pain and a positive urinary pregnancy test, bleeding per vagina for 5days and an outside ultrasound (USG) suggestive of a complex 4cm right adnexal mass, likely a cornual ectopic pregnancy. Her last menstrual period was on 27/4/23 and the complete lack of amenorrhea at all for a large tubal ectopic was suspicious.

Later she informed us that during her 2^nd miscarriage in August 2020, she had a dilatation and evacuation, and she had a molar pregnancy. There were no notes/slides/histopathology report. Verbally she was told that she did not need chemotherapy, as on serial assessment serial beta hCG had normalised by Dec-Jan 2021. Her serum b HCG on admission on 20/5/2023 was 41,270 U/l with normal CA125, LDH and AFP. Her pelvic USG done in our hospital, revealed an enlarged 12x6 cm uterus with an empty cavity, with a 1x1 cm hypervascular cystic lesion in anterior myometrium subserosally, and a 5.5x4.2x6.6cm right adnexal highly vascular multicystic likely neoplastic tumour between right ovary and uterus (Figures 1 & 2).