Ms. Li from Shimen, Hunan, has always felt that menstruation is much more frequent than before in the past six months, and the “big aunt” who would have been clean in the past three days or so has to wait a week or even half a week. For about a month, the key is to slowly a lump in the lower abdomen.
Ms. Li rushed to the Hunan Second People’s Hospital (Hunan Provincial Brain Hospital) accompanied by her family members.
Through examination, the hospital Professor He Weifeng from the Department of Oncology found that Ms. Li’s uterine cavity had strings of similar shapes. The tumor of grapes, and the uterus is larger than that of women of the same age, and the serum β-human chorionic gonadotropin (β-HCG) suggesting possible pregnancy reaches more than 300,000 mU/ml!
Further pathological examination revealed that Ms. Li was suffering from a malignant tumor originating from placental trophoblastic cells – uterine “erosive mole”!
So, what is an erosive mole of the uterus?
The mole is a type of gestational trophoblastic disease, with an incidence of 2/1000 pregnancies in China and some parts of Asia, both benign and malignant lesions.
Benign lesions include complete moles and partial moles.
The so-called malignant hydatidiform mole, also known as erosive hydatidiform mole, is different from benign hydatidiform mole in that benign hydatidiform mole is limited to the uterine cavity and dormant
strong>;
while malignant moles “move around”, infiltrating the myometrium and invading adjacent organs such as the vagina; It can penetrate the uterine wall and cause massive intra-abdominal bleeding; it can also invade the ligaments next to the uterus to form a parametrial tumor; more seriously, it can also “travel through mountains and rivers” and transfer to the lungs and head through blood circulation, threatening the patient’s life!
(Multiple vesicular abnormal structures and parametrial masses were found in the inner surface of the uterus by magnetic resonance examination)
It is precisely because of this nature that it is easy to spread widely, so it is similar to benign tumors. Molar pregnancy belongs to two diseases with completely different prognosis.
Professor He Weifeng pointed out that when the following situations occur after pregnancy, the possibility of hydatidiform mole should be considered:
1. Vaginal bleeding after menopause, usually 2 to 3 months of pregnancy Pregnant women are more common;
2. The uterus is abnormally enlarged;
3. The pregnancy reaction is severe, especially pregnancy vomiting, which not only appears earlier, but also lasts longer than normal pregnancy long;
4. Ovarian cysts appeared.
Some also have symptoms such as abdominal pain, bloating, high blood pressure, proteinuria, hyperthyroidism, and in rare cases hemoptysis, headache, epilepsy symptoms of distant metastasis.
Then how to check for moles?
Professor He Weifeng reminded that the means of diagnosing hydatidiform mole is not complicated at all, the key is to be vigilant and check in time.
The specific methods include: one is uterine ultrasonography; the other is blood examination for tumor markers, β-hCG will be significantly elevated. In this case, this increase in β-hCG is not only one of the signs of diagnosis, but also a key indicator of curative effect monitoring!
(abnormal features found by ultrasonography)
The mole can be divided into benign and malignant, so the treatment of mole involves Obstetrics and gynecology, oncology, pathology, etc. require close multidisciplinary cooperation and individualized diagnosis and treatment according to different situations.
Professor He Weifeng introduced that for the treatment of hydatidiform mole, the first thing to do is to remove the residual hydatidiform mole tissue in the uterine cavity to minimize the tumor burden. At the same time, you can also obtain tissue, send for pathology, and determine the final diagnosis!
The next thing to do is chemotherapy. Malignant mole is a tumor that is highly sensitive to chemotherapy, and can even be cured by chemotherapy; chemotherapy generally requires 4 -6 cycles, the specific number of cycles is adjusted according to the value of β-hCG.
Professor He Weifeng reminded that there are many reasons for the abnormal menstrual cycle and quality of middle-aged women, which should be analyzed according to the specific situation. Gynecological examination.
Even if you suffer from a malignant mole, there is no need to worry. Early diagnosis and timely and regular chemotherapy can completely achieve the purpose of cure.
(edited by Rainbow. Some pictures are from the Internet, invaded and deleted)
Special author of Hunan Medical Chat: Zhao Danrendou, Department of Oncology and Hematology, Hunan Second People’s Hospital (Hunan Brain Hospital)