Complete molar pregnancy in postmenopausal women

Gestational trophoblastic disease (GTD) is an abnormal proliferation of trophoblastic tissue during pregnancy. It is a disease of reproductive age, and a few cases have also been seen in women with advanced age, although it is extremely rare in postmenopausal women. Here, we describe an uncommon case of complete hydatidiform mole (CHM) in a postmenopausal woman, who has presented to us with complaints of bleeding per vagina, vomiting with 22 weeks size gravid uterus. Ultrasound finding along with raised serum beta-human chorionic gonadotropin (β-HCG) 400,000 mIU/ml suggested the diagnosis of CHM. In view of postmenopausal status and future risk of postmolar gestational trophoblastic neoplasia, we performed a total abdominal hysterectomy. Uterus was 20 cm × 15 cm × 15 cm filled with cystic, grapes such as vesicles. Microscopic examination demonstrated generalized trophoblastic proliferation with hydropic degenerated villi suggested of benign CHM. Follow-up showed steady fall in serum β-HCG level and no evidence of any residual disease. A suspicion of GTD should be kept in mind while evaluating a patient with peri- or post-menopausal bleeding so that it will prevent a delay in diagnosis and treatment.