Obstet Gynecol Sci.  2017 Nov;60(6):616-620. 10.5468/ogs.2017.60.6.616.

Persistent low-level elevation of serum human chorionic gonadotropin after termination of pregnancy: a rare case of peritoneal trophoblastic implant

• Seo HW
• Jeong MJ
• Namkung J
• Kim CJ
• Kwon JY

• KMID: 2418367
• DOI: http://doi.org/10.5468/ogs.2017.60.6.616

Abstract

Peritoneal trophoblastic implant can occur after treatment of ectopic pregnancy. Similarly, after termination of intrauterine pregnancy, trophoblastic implants are rare but can be a complication of perforation during dilatation and curettage. We report an extremely rare case of trophoblastic implant on the myometrium, ovarian surface, and peritoneal wall 4 months after uncomplicated dilatation and curettage. To the best of our knowledge, this is the first case of peritoneal trophoblastic implant following dilatation and curettage without uterine perforation. Knowledge of this case is useful for the management of patients with persistent low-level elevation of serum human chorionic gonadotropin after termination of pregnancy.

Keyword

Chorionic gonadotropin; Trophoblast; Dilatation and curettage

MeSH Terms

Animals
Chorionic Gonadotropin*
Dilatation and Curettage
Female
Humans*
Mice
Myometrium
Pregnancy*
Pregnancy, Ectopic
Trophoblasts*
Uterine Perforation
Chorionic Gonadotropin

Figure

• 

  Fig. 1 (A) Transvaginal ultrasound image showing a 2.00×2.18 cm mixed echoic mass in the myometrium of the uterine fundus. (B) Color Doppler examination reveals increased flow to the mass. (C) Sagittal T2-weighted pelvic magnetic resonance imaging showing a 2.3×1.3 cm mass with heterogeneous signal intensity in the uterine fundus.

• 

  Fig. 2 Laparoscopic findings showing brown and bluish masses on the fundus (A), left ovary (B), and left broad ligament (C). A cross-section of the uterus showing a hemorrhagic cystic mass in the fundal myometrium from the endometrial cavity (D).

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