Pulmonary deportation of hydatidiform mole: a 12-year, single tertiary center experience in China.

Background Pulmonary deportation of hydatidiform mole is an exceedingly rare entity. The underlying mechanisms and proper management strategies remain unclear based on sporadic case reports over the past six decades. This study aimed to investigate the clinical features and rational treatment of patients with benign molar pregnancies with pulmonary deportation based on our experience. Methods Medical records of 20 cases of hydatidiform mole with pulmonary deportation were retrospectively reviewed at Peking Union Medical College Hospital from November 2006 to May 2019. The detailed information of all patients was recorded and analyzed. Patients were divided into different groups according to their characteristics and Mann-WhitneyUtest was used to compare the duration to achieve a normal beta-human chorionic gonadotrophin (beta-hCG) level after the first evacuation among groups. Results Initial pulmonary computed tomography scans showed suspected bilateral, left and right chest deportation of hydatidiform mole in 12, four, and four patients, respectively, with the maximum nodular diameter ranging from 0.6 to 1.2 cm. Ten patients achieved lesion resolution while the remaining ten patients achieved decreases in the size of their pulmonary lesions. The median duration to achieve a normal beta-hCG level after the first evacuation was 15.5 (13.0, 21.9) weeks. There was no significant difference in the duration to achieve a normal beta-hCG level after the first evacuation between two groups based on age (>= 40 yearsvs. < 40 years: 15.8 [12.2, 21.5] weeksvs. 15.5 [12.9, 23.0] weeks,Z = 0.094,P = 0.925), type of antecedent mole (partial molevs. complete mole: 15.2 [12.5, 27.4] weeksvs. 15.9 [12.9, 21.5] weeks,Z = 0.165,P = 0.869), distribution of pulmonary nodules (bilateral lungsvs. unilateral lung: 15.2 [12.8, 22.5] weeksvs. 15.9 [13.2, 22.2] weeks,Z = 0.386,P = 0.700), maximum size of pulmonary nodules (>0.5 cmvs. <= 0.5 cm: 13.0 [11.3, 17.2] weeksvs. 16.0 [14.5, 23.8] weeks,Z = 1.815,P = 0.070), and number of uterine evacuations (oncevs. twice or three times: 15.0 [13.0, 16.3] weeksvs. 16.0 [12.8, 23.9] weeks,Z = 0.832,P = 0.405). The post-molar cohort was followed up for 17 to 139 months, and no gestational trophoblastic neoplasia was observed. Conclusions No surgeries other than uterine evacuation and no chemotherapy regimens are recommended for such patients if they achieve satisfactory decreases in the level of hCG and gradual decrease or disappearance of pulmonary deportation nodules. Patients should be informed about the necessity of long-term follow-up. More collaborative international studies on this exceedingly rare condition may guide decisions regarding optimal management strategies.