Question

Conversion of a complete hydatidiform mole into an invasive mole is indicated by all of the following except:

• A. Plateau in hCG
• B. Enlarged uterine size
• C. Persistence of theca lutein cysts
• D. Suburethral nodule

Hint:

Plateauing hCG, a bulky uterus and persistent theca lutein cysts all warn of conversion.

Answer 1

The Correct Option is D

Step 1: Understand the question. After evacuating a complete mole, certain signs warn that the disease has become an invasive mole or persistent trophoblastic disease. The question asks which finding is NOT such a sign.
Step 2: Review the genuine warning signs.
Plateau in hCG (option A): if serial beta-hCG fails to fall and instead stays flat over several weeks, this signals persistent or invasive trophoblastic disease. So A is a true sign of conversion.
Enlarged uterine size (option B): a uterus that re-enlarges or stays bulky after evacuation suggests ongoing invasive trophoblastic tissue. So B is a true sign.
Persistence of theca lutein cysts (option C): these ovarian cysts form from high hCG; if they persist, hCG is still high, again indicating ongoing disease. So C is a true sign.
Step 3: Examine option D, suburethral nodule. A suburethral nodule is not a recognised marker of molar conversion. (Vaginal metastatic nodules of trophoblastic disease are typically suburethral or in the lower vagina in choriocarcinoma, but the listed term as a marker of invasive mole conversion is the odd one out here.)
Step 4: The three accepted indicators are plateauing hCG, persistent uterine enlargement and persistent theca lutein cysts. The exception is the suburethral nodule. The answer is option D.