A 26-year-old woman presents with persistent low beta-hCG after uterine evacuation for a complete hydatidiform mole. Her serum beta-hCG is 1200 IU/L at 6 weeks post-evacuation, having plateaued for 3 consecutive weekly measurements. She has no metastatic disease on staging. According to FIGO criteria, what is the diagnosis?
- A Complete hydatidiform mole — normal regression
- B Gestational trophoblastic neoplasia (GTN) ✓
- C Partial hydatidiform mole with delayed regression
- D Invasive mole requiring MRI confirmation before treatment
Correct answer: B. Gestational trophoblastic neoplasia (GTN)
Explanation
FIGO diagnostic criteria for GTN after hydatidiform mole include: (1) plateau (±10%) of beta-hCG over 4 consecutive weekly measurements across 3 weeks, (2) rise of beta-hCG >10% over 3 weekly measurements across 2 weeks, (3) beta-hCG remaining elevated 6 months post-evacuation, or (4) histological diagnosis of choriocarcinoma or PSTT/ETT. A plateau over 3 measurements across 3 weeks satisfies criterion 1, establishing GTN diagnosis — treatment should not await further imaging confirmation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.