Gestational trophoblastic disease in the late postpartum period

Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumors arisingfrom defective proliferation of trophoblastic tissue. Its incidence after term pregnancy is infrequent, being diagnosed in most cases incidentally, due to symptoms of metastasis. We present a case of GTD that occurred 9 weeks after a vaginal delivery at term. The serum beta-human chorionic gonadotropin (beta-hCG) level was 38 084 mIU/mL and a chest CT scan showed multiple pulmonary nodules. The patient received actinomycin D for 3 cycles. The beta-hCG normalized after the third cycle and the patient remained disease-free for 12 months after diagnosis. The clinical presentation and challenges in diagnosing GTD in the late postpartum period are described.