The diagnosis is usually suspected after an ultrasound examination of the uterus , but absolute diagnosis of a mole is made by examining the cysts under a microscope. A serum ßHCG level far in excess of that of a normal pregnancy would support the diagnosis of a hydatidiform mole.
An invasive mole is seldom diagnosed definitively without a hysterectomy . The diagnosis is usually made after a hydatidiform mole is removed and there is a persistently elevated ßHCG titer without evidence of metastases.
Confirmation of choriocarcinoma by removing cells for pathological analysis is not required and may be hazardous since this tumor bleeds easily. The diagnosis is made by the presence of metastases and an elevated ßHCG level or, occasionally, on a D&C specimen.
Physical Examination
• When GTD is suspected or diagnosed, the physical examination pays particular attention to the pelvis,
abdomen (specifically the liver), the lungs and the brain.
