Objectives Molar pregnancy occurring at an ectopic site is a rare phenomenon. Such cases are mostly found either in fallopian tubes, uterine cornua or in the ovaries. Only one case of broad ligament molar pregnancy has been reported in literature so far and ours being the first case of a broad ligament ectopic molar pregnancy progressing to GTN. This case report is being presented with the objective of raising the awareness of molar pregnancies occurring at ectopic sites and highlighting the importance of follow-up for such rare cases.
Methods A suspected case of ruptured right tubal ectopic pregnancy presented to emergency with suspiciously high beta HCG level of 85000 mIU/ml. Intraoperatively a distinct mass, separate from uterus and fallopian tube measuring around 8 cms was seen between the leaves of broad ligament. Right salpingo-ophorectomy with excision of broad ligament and right pelvic peritoneum was done. On final histopathology, a diagnosis of broad ligament ectopic complete molar gestation was made.
Results Because of high initial beta HCG levels, large size of ectopic molar mass and fear of losing the patient to follow-up, prophylactic chemotherapy with single agent methotrexate 50 mg alternating with folinic acid was started. After a brief fall, post surgery, beta HCG started rising for three consecutive weeks despite continued chemotherapy. Gradually with dose modification of methotrexate to 75 mg (6 cycles) she responded and continues to be in remission after seven months.
Conclusions This bizzare case clearly substantiates the existence of such rare conditions and also reinforces the importance of follow-up.
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