A hydatidiform mole in a postmenopausal woman


  • Mohana Dhanapal Department of Obstetrics and Gynaecology, GMKMCH, Salem, Tamil Nadu, India
  • . Padmapriya Department of Obstetrics and Gynaecology, GMKMCH, Salem, Tamil Nadu, India
  • Anbarasi Pandian Department of Obstetrics and Gynaecology, GMKMCH, Salem, Tamil Nadu, India




Postmenopausal women, Pregnancy, Beta HCG, Hydatidiform mole


Gestational trophoblastic disease occurs in less than 1 per 1200 pregnancies. The spectrum of this disease ranges from benign hydatidiform mole to trophoblastic malignancy (placental-site trophoblastic tumor and choriocarcinoma). Benign gestational trophoblastic disease generally occurs in women of reproductive age and is extremely rare in postmenopausal women. We report a case of a 54-year-old postmenopausal woman who underwent an emergency total abdominal hysterectomy due to uncontrollable vaginal bleeding associated with an increased serum β-human chorionic gonadotropin level. The resected uterus contained an endometrial, cystic, grapelike tumor. Microscopic examination demonstrated hydropic degenerated villi with a circumferential trophoblastic cell proliferation and moderate atypia, consistent with a complete hydatidiform mole. Only isolated cases of hydatiform mole in elderly women have been reported in literature. But there still remains a risk of developing gestational trophoblastic disease in the elderly and it should always be included in the differential diagnosis of postmenopausal bleed.


Tevassoli FA, Deville P, eds. World health organisation classification of tumors pathology and genetics of tumors of the breast and female genital organs. Lyon IARC Press; 2003: 218.

Freedman RS, Tortolera-Luna G, Pandey DE, Malpica A, Baker VV, Whittaker L, et al. Gestational trophoblastic disease. Obstet Gynecol Clin North Am. 1996;23:545-71.

Shaw text book of gynaecology Howkine and Bournes, Chapter 22; 2017: 311.

Jeffcoates text book of gynaecology, Chapter 10; 2017: 148.

Berek and Novak text book of gynaecology, Chapter 39, 15th edition. 2011: 1458-1459.

Tsukamoto N, Iwasaka T, Kashimura Y, Uchino H, Kashimura M, Matsuyama T. Gestational trophoblastic disease in women aged 50 or more. Gynecol Oncol. 1985;20:53–61.

Lok CAR, Zurcher AF, Vandervelden J. A case of hydatidiform mole in a 56 year old women. Int J Gynaecol Cancer. 2005;15:163-6.

Bandy LCC, Clarke-Pearson DL, Hammond CB. Malignant potential of gestational trophoblastic disease at the extreme ages of reproductive life. Obstetric Gynaecol. 1984;64(3):395-9.

Gemer O, Segal S, Kopmar A, Sassoon E. The current clinical presentation of complete molar pregnancy: the current clinical presentation of complete molar pregnancy. Arch Gynecol Obstet 2000;264:33–4.

Castrillon DH, Sun D, Weremowicz S, Fisher RA, Crum CP, Genest DR. Discrimination of complete hydatidiform mole from its mimics by immunohistochemistry of the paternally imprinted gene product p57KIP2. Am J Surg Pathol. 2001;25:1225–30.

Al-Bozom IA. P53 and Bcl-2 oncoprotein expression in placentas with hydropic changes and partial and complete moles. APMIS. 2000;108:756–60.

Davidson SA, Gottesfeld J, La Rosa FG. Molar pregnancy in a 60-year-old woman. Int J Gynecol Obstet. 1997;56:53–5.






Case Reports