The patient was referred for pelvic MRI for a suspicious uterine lesion on ultrasound.

Serum β-hCG was markedly elevated at about ~ 750,000 IU/L.

The histopathology of suction - evacuation specimen showed: multiple pieces of decidua, multiple chorionic villi with hydropic changes and mild polar circumferential trophoblastic proliferation, consistent with molar pregnancy-partial mole.

Although β-hCG dropped to 20,000 IU/L after evacuation, it increased back to 95,000 IU/L after two weeks, raising suspicion of persistent gestational trophoblastic neoplasia (GTN). 

The patient was started on chemotherapy, β-hCG dropped back to ~20,000 IU/L after the first dose, and reached ~ 6 IU/L after the fifth dose, and now on monthly β-hCG monitoring as a follow-up plan.