A 35 year-old nulliparous white woman was referred to the Department of Obstetrics and Gynecology at the University of Bari in July 2007 with a 6 weeks’ history of amenorrhea and increased level of serum human Chorionic Gonadotropin 125 IU/ml. Transvaginal ultrasound revealed the presence of a 2 × 2 cm right adnexal mass and diagnosis of ectopic pregnancy was placed. HCG level dropped in the next days to 38 and remained stable for the next two months. Diagnosis of persistent trophoblastic disease was made and the patient received 3 cycles of metothrexate (1 mg/sqm on day 1-3-5-7 with folinic acid rescue) but h-CG levels remained still stable (31 UI/ml). Pelvic ultrasound, total body CT scan, MRI of the pelvis, D&C were all negative. Diagnostic laparoscopy was performed but no pathologic finding was found. Blood samples revealed nohyperglycosilated hCG which is specific to trophoblastic disease.
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Published online: November 10, 2017
Received: July 5, 2017
© 2017 Published by Elsevier Ireland Ltd.