Gestational Trophoblastic Disease and its Cervical Implantation: Case Report and Review of the Literature

Gestational trophoblastic disease is a generic term for a diverse group of medical conditions. The WHO classification of gestational trophoblast disease includes complete and partial hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT), epitheloid trophoblastic tumor (ETT), exaggerated placental site and placental site nodule. Molar pregnancies usually present in the first trimester but are a very rare event. The most common symptom is vaginal bleeding in combination with excessive beta-human chorionic gonadotropin (beta-hCG) levels. Therapeutic options are a systemic application of methotrexate or surgery. Hydatidiform moles may have an extrauterine or a cervical location. Presumably, the risk factors for an ectopic localization are similar to those for non-molar pregnancies. Currently, only three cases of cervical hydatidiform molar pregnancies have been reported in the literature. In all three cases the women presented with severe vaginal bleeding and were treated with methotrexate or surgery. In summary, careful surgical treatment during curettage is necessary to avoid molar ectopic pregnancies.