Introduction/Background Invasive hydatid mole, rare among gestational trophoblastic diseases, is a highly treatable malignancy. While it is usually observed in the reproductive period, its incidence is very low in the perimenopausal period.

Methodology A 48-year-old perimenopausal patient with Gravida 4, Parity 4, presented with abnormal uterine bleeding. The beta hCG result of the patient who had her last delivery as normal delivery at term in 2004 was reported as >10,000. In the gynecological examination, the uterus was observed to be approximately 12 weeks of gestation, and the uterine cavity was filled with a heterogeneous and vesicular mass approximately 6 cm in diameter. Firstly, endometrial sampling was recommended to the patient. A hysterectomy decision was made considering age, expectation of pregnancy, symptoms, and the risk of bleeding during the procedure.

Results In the pathology report after total abdominal hysterectomy and bilateral salpingo-oophorectomy, the tumor diameter was 8x7x5 cm and limited to the myometrium. At the same time, lymphovascular space invasion and perineural invasion were not observed. Beta hCG value decreased to 3998 two days after the operation, 413 after thirteen days, and 2 after about two months. In the sixth month of the operation, the beta hCG value remains negative. Abdominal and thorax imaging did not show any findings regarding recurrence or metastasis.

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Abstract #643 Figure 1

Invasive mole piece

Conclusion Gestational trophoblastic diseases, which are rare but can be detected by beta hCG value, should be considered in patients presenting with abnormal uterine bleeding in the perimenopausal period.

Disclosures Since the beta hCG values of the patient decreased rapidly after the operation and no metastases were detected, a 12-month follow-up was recommended, weekly until the beta hCG value was negative and monthly after it became negative.