Case Study and Case Report 2022; 12(3): 25 - 28.

Mindra A, Mindra P. Persistently elevated β-human chorionic gonadotropin level after vacuum-assisted uterine aspiration. Case Study and Case Report 2022; 12(3): 25 - 28. ABSTRACT Urothelial bladder carcinoma accounts for nearly 90% of all bladder cancers. Cigarette smoking, chronic cystitis, and human papillomavirus infection are all risk factors. Hematuria, obstructive voiding, and irritative symptoms are common symptoms. Despite the prevalence of urothelial carcinoma, elevation of -human chorionic gonadotropin in these tumors is uncommon. This case report alerts gynecologic practitioners to the possibility of urologic causes of -human chorionic gonadotropin elevation, even in the setting of a recent spontaneous abortion, and provides a comprehensive review of diagnostic testing in the setting of -human chorionic gonadotropin elevation. In the setting of significant vaginal bleeding, a 46-year-old non woman, former smoker, with a history of polycystic ovary syndrome, high-risk human chorionic gonadotropin infection, and hypertension, underwent vacuum-assisted aspiration. Pathology confirmed the presence of fetal tissue. Human chorionic gonadotropin levels fell to 10.5 mU/mL and were no longer monitored due to the resumption of menstruation. Her human chorionic gonadotropin level was found to be elevated six months later during a routine preoperative evaluation for orthopedic surgery. She also had asymptomatic hematuria that persisted. She underwent a thorough gynecologic and urologic work-up that included hysteroscopy, dilation and curettage, methotrexate therapy, computerized tomographic imaging, and cystoscopy before being diagnosed with urothelial carcinoma. Keywords: β-human chorionic gonadotropin, vacuum-assisted uterine aspiration, bleeding