A 26-year-old woman 6 weeks after hydatidiform mole evacuation has plateaued serum β-hCG levels (three consecutive weekly readings: 210, 218, 205 IU/L). Ultrasound shows no intrauterine mass. Chest X-ray is normal. According to FIGO 2000 GTD criteria, she has:
- A Choriocarcinoma requiring urgent EMA-CO chemotherapy
- B Normal post-mole surveillance; continue monitoring for 4 more weeks
- C Gestational trophoblastic neoplasia (GTN) requiring single-agent chemotherapy ✓
- D Partial hydatidiform mole requiring repeat curettage
Correct answer: C. Gestational trophoblastic neoplasia (GTN) requiring single-agent chemotherapy
Explanation
FIGO 2000 criteria for diagnosis of gestational trophoblastic neoplasia (GTN) after hydatidiform mole include: plateau (≤10% rise over 3 consecutive weekly measurements) or rise in β-hCG over 3 or more weeks. A plateau for 3 weeks meets GTN criteria. GTN is treated with chemotherapy; with normal CXR and no metastases, this patient's WHO score determines single-agent (low-risk) versus EMA-CO (high-risk) treatment.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.