2011 Volume 63 Issue 4 Pages 505-509
Thyroid function is known to be enhanced in patients with trophoblastic disease because of an increase in the serum levels of human chorionic gonadotropin (hCG). However, few patients show clinical hyperthyroidism. We report a rare case of hydatidiform mole complicated with thyrotoxicosis. A 52-year-old multiparous woman complained of genital bleeding for 4 months after her last menstrual period. She visited a local clinic for loss of appetite, leg edema, and abdominal distention and was referred to our hospital. She was diagnosed with thyrotoxicosis because of elevated levels of free T4 (FT4) (3.52 mg/dl) and low levels of thyroid stimulating hormone (TSH) (less than 0.01 μU/ml). A huge abdominal mass was also detected. Imaging studies showed an enlarged uterus. Endometrial cytology showed trophoblast cells and a marked elevation of serum hCG levels (681676 mIU/ml). These findings were suggestive of trophoblastic disease and thus hysterectomy was planned. Two days before the operation, intrauterine contents were spontaneously exhausted. Total abdominal hysterectomy was performed according to plan. Histological examination revealed an invasive mole. After the operation, serum hCG level decreased gradually and has not increased for 1 year. Thyroid hormone level has also been normal. Thus, consideration of hyperthyroidism is important in the treatment of trophoblastic disease. [Adv Obstet Gynecol, 63(4) : 505-509, 2011 (H23.11)]
