Role of mechanical hysteroscopic tissue removal system in post-molar gestational trophoblastic neoplasia management: case report and literature review.

Abstract

Complete hydatidiform moles are precancerous gestational trophoblastic diseases, with 15%-20% progressing to post-molar neoplasia. The gold standard treatment of low-risk neoplasia is single-agent chemotherapy. A second curettage is an alternative to avoid chemotherapy; hysteroscopic resection is not described in the guidelines. We report a case of post-molar neoplasia treated using a mechanical hysteroscopic tissue removal system (TruClear°) and review the limited literature on the subject. A patient was diagnosed with low-risk post-molar neoplasia in our department. Ultrasound evaluation revealed uterine trophoblastic retention, which was managed with mechanical hysteroscopic resection. In conclusion, hysteroscopic resection could be a potential alternative to second curettage in highly selected cases of low-risk post-molar neoplasia.