15 January 2025
: Case report 
Invasive Hydatidiform Mole Mimicking Ectopic Pregnancy: A Case Report and Literature Analysis
Challenging differential diagnosis, Unusual setting of medical care, Rare disease
Amany A. Fathaddin ABCDEF 1*DOI: 10.12659/AJCR.946388
Am J Case Rep 2025; 26:e946388
Table 2. Reported cases of invasive molar pregnancy in the fallopian tube.
| Author | Patient’s characteristics | β-hcg level at presentation And Prognostic score | Side | Management | Chemotherapy | Outcome |
|---|---|---|---|---|---|---|
| Juan (2013) []1 | A 20-year-old woman (G2, P1) presented at the emergency room with severe low abdominal pain 8 weeks and 4 days after her last menstrual period | 6984 mIU/mL Prognostic score was not mentioned | Left fallopian tube | Laparoscopy and salpingectomy for a left ampullary ectopic pregnancy | Not given | Weekly quantitative β-hCG titers were performed until 3 successive β-hCG levels were negative |
| Toal et al (2021) []2 | A 31-year-old woman (G4P2+1) with an uncertain last menstrual period who presented to the Emergency Department with vaginal bleeding | 103,724 mIU/mL Prognostic score: Stage I low-risk with a WHO score of 5 | Right fallopian tube | Laparoscopic right cornual wedge resection and right salpingectomy | Methotrexate 0.4 mg/kg IM for 5 days every 14 days | At the time of most recent follow-up 3 months following therapy completion, the patient had no evidence of disease and a negative β-hCG |
| Obahiagbon et al (2018) [] (2 cases)4 | Age range: 20–29 amenorrhea, pelvic pain, and bleeding per vagina | Not mentioned (The cases were among other reported ectopic GTDs with histopathology review only Article title: “Ectopic Gestational Trophoblastic Disease: A 20-Year Histopathological Review in a Tertiary Center)” | Right and left fallopian tubes (respectively) | Not mentioned | Not mentioned | Not mentioned |
| Zhang et al (2014) []6 | A 30-year-old woman (G 2 P 1) presented with amenorrhea and vaginal bleeding | 13411 mIU/ml. Prognostic score: Stage III according to FIGO 2000 | Right fallopian tube | Laparoscopy right salpingooophorectomy | Five days chemotherapy with methotrexate (MTX) 10 mg/m/d plus 5-fluorouracil (5-FU) 800 mg/m/d plus etoposide (VP-16) 60 mg/m/d | The final diagnosis of the patient was an invasive mole in fallopian tube with ovarian metastasis. The serum β-hCG level decreased to 51.95 mIU/ml after the first cycle of chemotherapy and fell into the normal range after the 2 cycle of chemotherapy and still maintained within normal limits for more than 12 months (the 5 measurement) |
| Khlif et al (2016) []7 | A 40-year-old woman (G1 P0), presented at 7 weeks of amenorrhea with sudden acute pain located in the left iliac fossa | 27 624 mIU/ml. Prognostic score: Not mentioned; however, CT scan showed no locoregional or distant metastases | Left fallopian tube | Laparoscopic left salpingectomy | 8 cycles of Methotrexate (dose was not mentioned) | The outcome was favorable with negativity hCG plasma (monitored weekly) after 8 cycles of chemotherapy and the patient was in complete remission up to 48 months post-treatment |
| Ikuma et al (1992) [] (Japanese)8 | A 41-year-old woman (G3 P0 +2) presented at 9 weeks of amenorrhea with abdominal pain and vaginal bleeding | 16 000 mIU/mL Prognostic score: Not mentioned | Isthmus of left fallopian tube | Simple total hysterectomy and left salpingooophorectomy | One course of MTX (10 mg/day ×5 days) | Favorable outcome, negative hCG was achieved, complete remission up to 12 months |