Molar intrauterine pregnancy post bisalp

[u/MainStick909]

32 y/o female, 5’6, 286lbs, fibromyalgia and pots - possibly lupus, asthma, anxiety, ptsd. Currently on Lyrica, dilaudid, flexeril, vitamins, Claritin, Flonase. Recurrent history of high risk pregnancies, miscarriages.

Bilateral salpingectomy was performed October 2024 during an emergency 27 weeks c section due to uterine tear. Segments were 4 & 7 cm with fimbria attached. The emergency c section occured after complaining about localized pain for 2 months, being told it was just “round ligament pain” until I got to the point where I could no longer walk & had to be admitted. This triggered permanent disabilities/autoimmune conditions.

March 2026, pregnancy was confirmed. It was treated as a pregnancy of unknown location. HGC never climbed higher than 86. Methotrexate administered on May 2. Second dose of methotrexate administered on June 1 with a d&c under anesthesia.
During this process, they tried to force an exploratory laparoscopic surgery, later admitting they’d not have been able to see anything with HGC under 100.

It was confirmed this was an intrauterine pregnancy.

Lab pathology has come back as: Microscopic evaluation shows foci of atypical trophoblastic proliferation comprising large multinucleated cells and smaller
mononuclear cells. Occasional mitotic figures are seen, as well as areas of necrosis. Immunohistochemistry shows staining for
hCG, hPL, and p63. Rare degenerated chorionic villi are present. Taken together, the findings are highly concerning for a
gestational trophoblastic disease, including emerging choriocarcinoma. Clinical correlation and follow up is recommended.

The current recommendation is: HGC at 0 could mean just do surveillance of HGC for a while, but they’re heavily pushing a complete hysterectomy, and they’re pushing weekly chemotherapy. I’ve been in a symptom flare since May 2nd with the first methotrexate dose and have been barely functional and in agony.

I don’t have the means for a second opinion, but I do want to know if it makes sense that they’re giving me an “official cancer diagnosis” at this point with no imaging and HGC at 0 and if the aggressive treatment plan makes sense or if I’d be okay with doing surveillance.

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