This is a case of recurrent hydatidiform mole in 30-year-old women. Initially diagnosed with a molar pregnancy in September 2020, underwent D&E and received methotrexate treatment, resulting in a decline of beta hCG levels to 0.8mIU/ml by December 2020. Subsequent ultrasound in March 2021 indicated a hydatidiform mole like picture despite of low beta hCG (<2.0mIU/ml). An MRI suggested similar findings without myometrial invasion, without enlarged lymph nodes or ascites. Histopathology of D&E sample showed endometrial hyperplasia rather than hydatidiform mole. Upon detailed history review, it was found the patient had been self-administering mifepristone at 25mg/day for over five months post the initial procedure. Literature search links extended high dose mifepristone usage to an unopposed estrogen environment, causes endometrial hyperplasia, alerting us to monitor prolonged mifepristone use meticulously.

Key words: Hydatidiform mole, Molar pregnancy, prolonged mifepristone

Nilakshi Phukan Kumar^1?, Subhendu Buzarbaruah

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