Incidental finding of endometrial carcinoma in a suspected molar pregnancy: a case report and review of literature

Incidental finding of endometrial carcinoma in a suspected molar pregnancy: a case report and review of literature | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Incidental finding of endometrial carcinoma in a suspected molar pregnancy: a case report and review of literature Yafang Tang, Charissa SY Goh, Qiu Ju Ng, Yen Ching Yeo, Felicia HX Chin This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7126241/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 11 Dec, 2025 Read the published version in BMC Women's Health → Version 1 posted 10 You are reading this latest preprint version Abstract Background Endometrium cancer is the most common gynecological cancer in women from developed countries. However, endometrial cancer is rarely seen during pregnancy. In literature, there are 34 cases reported since 1996 and majority were detected in the first trimester. We present a case of endometrial carcinoma in the background of suspected molar pregnancy. Case presentation A 39-year-old gravida 3 para 1 lady presented at 5 weeks and 3 days amenorrhea with per vaginal bleeding in Dec 2022. Her serum beta-HCG was 14634 IU/L and the ultrasound pelvis showed echogenic material in the endometrial cavity with no gestational sac. A follow-up serum beta-HCG at 48 hours showed a suboptimal rise to 22546 IU/L. Findings on a repeat ultrasound pelvis were suspicious of a molar pregnancy. She underwent evacuation of uterus. The histology showed focal well differentiated endometrioid adenocarcinoma with background complex atypical hyperplasia and complex hyperplasia without atypia. Products of conception were also confirmed. Staging scans confirmed radiological stage 1 disease. She declined fertility sparing treatment and opted for definitive surgery. She underwent a total laparoscopic hysterectomy, bilateral salpingectomy with sentinel lymph node biopsy. The final histology showed complex atypical hyperplasia with no residual endometrial adenocarcinoma. The patient recovered well and remained disease-free 21 months after surgery. Conclusion Suspicious radiological findings in early pregnancy should prompt meticulous histological evaluation to rule out malignancy. Although endometrial cancer is very rare in pregnancy, it is important for clinicians and pathologists to have high index of suspicion of this possible differential diagnosis. Endometrial cancer Pregnancy Progesterone Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 11 Dec, 2025 Read the published version in BMC Women's Health → Version 1 posted Editorial decision: Revision requested 01 Sep, 2025 Reviews received at journal 26 Aug, 2025 Reviews received at journal 17 Aug, 2025 Reviewers agreed at journal 10 Aug, 2025 Reviewers agreed at journal 04 Aug, 2025 Reviewers invited by journal 23 Jul, 2025 Editor invited by journal 18 Jul, 2025 Editor assigned by journal 17 Jul, 2025 Submission checks completed at journal 17 Jul, 2025 First submitted to journal 15 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7126241","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":490115687,"identity":"fb47c894-c2fb-466f-81fd-82bc9f96c3f5","order_by":0,"name":"Yafang Tang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYBAC+wNgSg6ImUFMCRmCWtgglDGImQDSwkOKFh4DEIsILexnD7/mqTGQN+df8/nVjRoLHgb2w0c34NXCk5dmzXPMwHDnjLfbrHOOAR3Gk5Z2A7/DcsyMedj+MG64cXabcQ4bUIsEjxl+LfxvgFr+GdhvuHHmmXHOP2K0SOQYP+ZtM0jccL6H+XFuG1Fa3pgxzu0zSN5wg82MObdPgoeNoF/4c4w/vPlmYLvh/OHHn3O+1cnxsx8+hlcLSJcUOC4kEtgkwFwCykGA+eMPEMV/gPkDEapHwSgYBaNgBAIAuBhGdqdiQEgAAAAASUVORK5CYII=","orcid":"","institution":"KK Women’s and Children’s Hospital","correspondingAuthor":true,"prefix":"","firstName":"Yafang","middleName":"","lastName":"Tang","suffix":""},{"id":490115689,"identity":"5519cdcb-1fc4-45e1-8b9d-97304a2b177f","order_by":1,"name":"Charissa SY Goh","email":"","orcid":"","institution":"KK Women’s and Children’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Charissa","middleName":"SY","lastName":"Goh","suffix":""},{"id":490115691,"identity":"c60b1af1-cc3b-4857-9a5c-273362929c31","order_by":2,"name":"Qiu Ju Ng","email":"","orcid":"","institution":"KK Women’s and Children’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Qiu","middleName":"Ju","lastName":"Ng","suffix":""},{"id":490115695,"identity":"32d03c69-7ab7-449e-a0a5-db4ef47ccf05","order_by":3,"name":"Yen Ching Yeo","email":"","orcid":"","institution":"KK Women’s and Children’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yen","middleName":"Ching","lastName":"Yeo","suffix":""},{"id":490115696,"identity":"de636f20-340e-4e3b-81a7-8b3e0f8004ed","order_by":4,"name":"Felicia HX Chin","email":"","orcid":"","institution":"KK Women’s and Children’s Hospital","correspondingAuthor":false,"prefix":"","firstName":"Felicia","middleName":"HX","lastName":"Chin","suffix":""}],"badges":[],"createdAt":"2025-07-15 04:53:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7126241/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7126241/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12905-025-04152-w","type":"published","date":"2025-12-11T15:58:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":98244840,"identity":"44a031ee-e053-47a3-a3fe-ff1f1f432745","added_by":"auto","created_at":"2025-12-15 16:15:34","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":622894,"visible":true,"origin":"","legend":"","description":"","filename":"EndometrialcarcinomainpregnancyBMC.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7126241/v1_covered_6218eebf-ea3e-469b-849f-a041f9efbeaf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Incidental finding of endometrial carcinoma in a suspected molar pregnancy: a case report and review of literature","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Endometrial cancer, Pregnancy, Progesterone","lastPublishedDoi":"10.21203/rs.3.rs-7126241/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7126241/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEndometrium cancer is the most common gynecological cancer in women from developed countries. However, endometrial cancer is rarely seen during pregnancy. In literature, there are 34 cases reported since 1996 and majority were detected in the first trimester. We present a case of endometrial carcinoma in the background of suspected molar pregnancy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCase presentation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA 39-year-old gravida 3 para 1 lady presented at 5 weeks and 3 days amenorrhea with per vaginal bleeding in Dec 2022. Her serum beta-HCG was 14634 IU/L and the ultrasound pelvis showed echogenic material in the endometrial cavity with no gestational sac. A follow-up serum beta-HCG at 48 hours showed a suboptimal rise to 22546 IU/L. Findings on a repeat ultrasound pelvis were suspicious of a molar pregnancy. She underwent evacuation of uterus. The histology showed focal well differentiated endometrioid adenocarcinoma with background complex atypical hyperplasia and complex hyperplasia without atypia. Products of conception were also confirmed. Staging scans confirmed radiological stage 1 disease. She declined fertility sparing treatment and opted for definitive surgery. She underwent a total laparoscopic hysterectomy, bilateral salpingectomy with sentinel lymph node biopsy. The final histology showed complex atypical hyperplasia with no residual endometrial adenocarcinoma. The patient recovered well and remained disease-free 21 months after surgery.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSuspicious radiological findings in early pregnancy should prompt meticulous histological evaluation to rule out malignancy. Although endometrial cancer is very rare in pregnancy, it is important for clinicians and pathologists to have high index of suspicion of this possible differential diagnosis.\u003c/p\u003e","manuscriptTitle":"Incidental finding of endometrial carcinoma in a suspected molar pregnancy: a case report and review of literature","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-25 13:07:34","doi":"10.21203/rs.3.rs-7126241/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-01T09:32:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-26T19:06:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-17T17:12:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"103832646758307174417871730410492549564","date":"2025-08-10T05:10:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"99369395472428796417713757716129597372","date":"2025-08-04T16:53:57+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-23T23:02:54+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-18T18:03:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-17T06:45:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-17T06:43:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Women's Health","date":"2025-07-15T04:43:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-womens-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmwh","sideBox":"Learn more about [BMC Women's Health](http://bmcwomenshealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmwh/default.aspx","title":"BMC Women's Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e9cab22e-7905-4a3f-aa9b-bbe8d67467f2","owner":[],"postedDate":"July 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T16:10:26+00:00","versionOfRecord":{"articleIdentity":"rs-7126241","link":"https://doi.org/10.1186/s12905-025-04152-w","journal":{"identity":"bmc-womens-health","isVorOnly":false,"title":"BMC Women's Health"},"publishedOn":"2025-12-11 15:58:00","publishedOnDateReadable":"December 11th, 2025"},"versionCreatedAt":"2025-07-25 13:07:34","video":"","vorDoi":"10.1186/s12905-025-04152-w","vorDoiUrl":"https://doi.org/10.1186/s12905-025-04152-w","workflowStages":[]},"version":"v1","identity":"rs-7126241","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7126241","identity":"rs-7126241","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}