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Case Reports in Medicine
Volume 2009, Article ID 454161, 3 pages
http://dx.doi.org/10.1155/2009/454161
Case Report

Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO

1Department of Gynaecology, Academic Hospital, Brussels Free University - (VUB), UZ Brussel, 1090 Brussels, Belgium
2Department of Oncology, Academic Hospital, Brussels Free University - (VUB), UZ Brussel, 1090 Brussels, Belgium

Received 20 February 2009; Accepted 3 April 2009

Academic Editor: Faustino R. Pérez-López

Copyright © 2009 M. De Vos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment. Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission. Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.