Recurrent Beta-Human Chorionic Gonadotropin (β-hCG) Elevation and Suspicion of Gestational Trophoblastic Neoplasia Following a Complete Hydatidiform Mole in a 17-Year-Old Female Patient: A Case Report.
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The patients with complete hydatidiform mole (CHM) often present with markedly elevated beta-human chorionic gonadotropin (β-hCG) levels, uterine enlargement, and trophoblastic hyperplasia, and may develop complications such as preeclampsia, hyperthyroidism, or theca lutein cysts. The risk of developing persistent gestational trophoblastic neoplasia (GTN) following CHM is substantially higher than with partial hydatidiform mole (PHM). We describe the case of a 17-year-old female patient referred for evaluation of abdominal distension, abnormal vaginal bleeding, and hypertension. Imaging and laboratory findings suggested a molar pregnancy. She underwent repeat uterine evacuations and received methotrexate therapy. Histopathological examination confirmed a CHM. Serial monitoring initially demonstrated a decline in β-hCG, but subsequent fluctuations and recurrent vaginal bleeding raised suspicion for post-molar GTN. The additional histological findings raised the possibility of an epithelioid trophoblastic tumor. Following several cycles, β-hCG levels steadily declined and eventually normalized. This case highlights the diagnostic and therapeutic challenges of molar pregnancy in adolescents. It underscores the importance of β-hCG surveillance, timely initiation of chemotherapy when regression fails, and careful histopathological evaluation. Early recognition and individualized management can prevent complications and improve outcomes in young patients at risk of post-molar GTN.