The following ultrasound images are from a 38 year old, with a h/o 8 weeks LMP, who presented with PV bleed. What radiological sign can you see in the images?[peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”]
The ultrasound images (transverse and longitudinal) show multiple cysts occupying the uterine cavity, giving rise to the ‘bunch of grapes sign’. This finding is suggestive of a molar pregnancy. There is no intrauterine gestational sac seen.
The patient had a very high serum quantitative hCG. She did not have any evidence of metastasis upon further tests. She underwent dilatation and curettage.
- More common at the extremes of reproductive age.
- Complete mole (no fetal tissue) or partial mole (fetal tissue present).
- Clinical presentation: PV bleeding, hyperemesis, hyperthyroidism (due to stimulation of the thyroid by high circulating hCG or production of thyroid stimulating substance by the trophoblastic tissue), pre-eclampsia.
- Very high quantitative hCG usually, but a normal hCG level is also a possibility.
- Baseline chest radiography must to r/o metastasis.
Reference – http://emedicine.medscape.com/article/254657[/peekaboo_content]