Post-Molar Gestational Trophoblastic Neoplasia After Ectopic Molar Pregnancy in Broad Ligament: A Rare Case Report

AbsrtactBroad ligament ectopic molar pregnancy is a rare pathology, and it is rarer for it to progress to neoplasia. We report the first case ever of an unruptured broad ligament ectopic molar pregnancy progressing to gestational trophoblastic neoplasia even after complete surgical removal. A 35-year-old female presented to emergency department with history of irregular vaginal bleeding for 3 months and acute onset of abdominal pain for few hours with positive urine pregnancy test. On screening ultrasound of pelvis, an ill-defined right adnexal mass was seen. Beta hCG level was 84,193.70 IU/mL. A CT abdomen was done, which was suggestive of right broad ligament thick-walled lesion with suspected haemorrhagic collection around the lesion. She was taken up for laparotomy, and a mass was found between the two leaves of right broad ligament. The mass was excised along with right fallopian tube. It constituted of fluid-filled vesicles typical of hydatiform mole which was later confirmed on histopathology as complete hydatiform mole. Post-operatively prophylactic chemotherapy was started. After initial fall in beta hCG, there was an unexpected rise in the levels leading to diagnosis of post-molar gestational trophoblastic neoplasia which was successfully treated with chemotherapy.