# Uterine Rupture on Invasive Molar Pregnancy Revealing a Choriocarcinoma: Case Report from a Low‐Income Country

## TL;DR

A rare case of uterine rupture caused by an invasive molar pregnancy leading to choriocarcinoma is reported in a low-income country.

## Contribution

This case report highlights a rare clinical presentation of gestational trophoblastic disease in a low-income setting.

## Key findings

- Uterine rupture was observed following an invasive mole revealing choriocarcinoma.
- The patient was treated with methotrexate–folinic acid chemotherapy but was lost to follow-up.
- Early diagnosis and treatment adherence are emphasized for better outcomes in such cases.

## Abstract

Gestational trophoblastic diseases are rare entities encompassing a wide spectrum of benign and malignant placental pathologies. Uterine rupture is primarily related to a uterine scar and, exceptionally, following an invasive mole or gestational choriocarcinoma. Our objective is to report a rare case of uterine rupture following an invasive mole revealing gestational choriocarcinoma.

A 23‐year‐old pregnant woman was admitted for genital bleeding complicated by hypovolemic shock. She presented with symptoms suggestive of a ruptured ectopic pregnancy. However, her hCG levels were markedly elevated, raising suspicion of gestational trophoblastic disease. A subtotal hysterectomy with bilateral salpingo‐oophorectomy and bladder repair was performed. Due to the lack of histopathology, the diagnosis of choriocarcinoma was clinically and biochemically inferred. Exclusive chemotherapy using the methotrexate–folinic acid protocol was initiated. The patient was lost to follow‐up after the first course.

The reported case is generally consistent with data from the literature. The practitioner must emphasize the highly curable nature of the disease to optimize patient adherence until the end of the treatment plan. Early diagnosis must be optimized to allow for conservative treatment.