What is the mainstay treatment for hydatidiform mole to prevent choriocarcinoma?

What is the mainstay treatment for hydatidiform mole to prevent choriocarcinoma?

• A. Surgical uterine evacuation
• B. Chemotherapy
• C. Radiation therapy
• D. Expectant management

Answer: (A)

Removing the molar tissue with suction curettage is the mainstay treatment because it immediately eliminates the abnormal trophoblastic tissue that is producing very high hCG. By evacuating the uterus, you reduce the source of disease, allowing hCG levels to fall and lowering the risk of progression to persistent gestational trophoblastic neoplasia or choriocarcinoma. After the procedure, serial hCG monitoring is essential to ensure the pregnancy-related tissue has been fully removed and to detect any persistent GTD early, which would then require chemotherapy. Chemotherapy is reserved for cases where hCG fails to decline or rises after evacuation, indicating persistent GTD or choriocarcinoma, not as initial management. Radiation therapy and expectant management aren’t appropriate options here, as they don’t address the abnormal tissue and can allow progression or cause harm.

Removing the molar tissue with suction curettage is the mainstay treatment because it immediately eliminates the abnormal trophoblastic tissue that is producing very high hCG. By evacuating the uterus, you reduce the source of disease, allowing hCG levels to fall and lowering the risk of progression to persistent gestational trophoblastic neoplasia or choriocarcinoma. After the procedure, serial hCG monitoring is essential to ensure the pregnancy-related tissue has been fully removed and to detect any persistent GTD early, which would then require chemotherapy. Chemotherapy is reserved for cases where hCG fails to decline or rises after evacuation, indicating persistent GTD or choriocarcinoma, not as initial management. Radiation therapy and expectant management aren’t appropriate options here, as they don’t address the abnormal tissue and can allow progression or cause harm.