scholarly journals Successful Pregnancy Outcome Within Short Period of Remission From Choriocarcinoma Treated with Single Agent Chemotherapy - A Case Report

2014 ◽  
Vol 40 (3) ◽  
pp. 29-32
Author(s):  
Asma Habib ◽  
Md. Mofazzel Hossain ◽  
Fauzia Jahan
Keyword(s):  
Pregnancy Outcome ◽  
Combination Chemotherapy ◽  
Cancer Biology ◽  
Hydatidiform Mole ◽  
Single Agent ◽  
Complete Hydatidiform Mole ◽  
Successful Pregnancy ◽  
Partial Hydatidiform Mole ◽  
Increased Risk ◽  
Short Period

Gestational trophoblastic tumour/disease (GTT/GTD) is unique it cancer biology in that they result from aberrations of either a normal or an abnormal pregnancy. The most common antecedent pregnancy event to GTT is a complete or partial hydatidiform mole (HM). However, persistent trophoblastic disease or choriocarcinoma can follow a complete hydatidiform mole with an incident of approximately 8%, and after a partial hydatidiform mole with an incidence of approximately 0.5%. The exact proportion of cases of hydatidiform mole transforming to choriocarcinoma cannot be clearly estimated, approximately 3% to 5% of cases of complete hydatidiform mole. 1-3 Therefore,  all patients with GTT need to be monitored so that the small proportion of persistent mole or choriocarcinoma can receive prompt treatment and elimination of their' disease. The recommendation stands as strict avoidance of pregnancy for at least one year after treatment of molar pregnancy or low risk non-metastatic gestational trophoblastic tumour. Pregnancy during this period of surveillance interferes with the sequential monitoring of abnormal trophoblastic activity by serum beta-human chorionic gonadotrophin levels and relapses become difficult to detect. The effect of single agent or combination chemotherapy on the totipotent oocytes usually wavers away during the recommended period of contraception. But in cases of pregnancy during the period of surveillance certain factors have been found to be associated with increased risk of relapse and teratogenic effects of the offspring. High risk/score (according to the FIGO scoring system ) and advanced stage Gestational trophoblastic tumour (GTT), short interval between pregnancy and remission from combination chemotherapy, poor compliance during the antenatal follow-up are linked with detrimental maternal and foetal outcome. Here we report a case of successful pregnancy outcome in a patient who conceived within 3 months of remission from choriocarcinoma treated by methotrexate as evidenced by 2 consecutive negative ?-human chorionic gonadotropin (?-hCG) values. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18671 Bangladesh Medical Journal 2011 Vol.40(3):29-32

scholarly journals A Case of Invasive Mole

2017 ◽  
Vol 12 (2) ◽  
pp. 86-87
Author(s):  
Shahana Ahmed ◽  
Dipti Rani Shaha
Keyword(s):  
Hydatidiform Mole ◽  
The Body ◽  
Emergency Laparotomy ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Partial Hydatidiform Mole ◽  
Normal Limits ◽  
History Of ◽  
Invasive Mole

Invasive mole is a condition where a molar pregnancy, such as a partial hydatidiform mole or complete hydatidiform mole, invades the wall of the uterus, potentially spreading and metastasizing to other parts of the body. Here is a case who presented with history of evacuation for molar pregnancy. She presented with irregular P/V bleeding on and off and after admission silent perforation with massive haemoperitoneum was detected for which emergency laparotomy was done. She recovered and was followed up till her b-hCG levels were within normal limits. As patient presented to us with haemoperitoneum and on laparotomy, there was invasion into whole of the uterus, it could not be saved and hysterectomy was done.Faridpur Med. Coll. J. Jul 2017;12(2): 86-87

scholarly journals Hydatidiform mole coexisting with normal foetus: A rare presentation of a case report from University of Maiduguri Teaching Hospital

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Abba Kabir ◽  
Abdulkarim A. Kullima ◽  
Adamu I. Adamu ◽  
Anna Peter ◽  
Abba Z. Bukar ◽  
...  
Keyword(s):  
Case Report ◽  
Twin Pregnancy ◽  
Hydatidiform Mole ◽  
Close Monitoring ◽  
Ultrasound Scan ◽  
Complete Hydatidiform Mole ◽  
Intrauterine Pregnancy ◽  
Rare Presentation ◽  
Increased Risk ◽  
Normal Foetus

A twin pregnancy comprising a complete hydatidiform mole coexisting with a foetus is a rare obstetric condition with an incidence of 1 in 22,000 to 1 in 100,000 pregnancies. The management of such case is challenging due to the associated risk of maternal and foetal complications. We report a case of a 25-year-old woman, gravida 2, para 1 with a normal intrauterine pregnancy coexisting with complete hydatidiform mole. An ultrasound scan demonstrated normal foetus and placenta along with coexistent intrauterine echogenic mass with features of hydatidiform mole. The microscopic examination of the abnormal placenta confirmed complete hydatidiform mole. Although twin pregnancy with complete hydatidiform mole and coexistent foetus is associated with increased risk of developing maternal and foetal complications, continuation of pregnancy may be an acceptable option under close monitoring to detect early signs of complications.

scholarly journals Coexistent molar pregnancy with a normal fetus-a rare presentation of gestational trophoblastic disease

2021 ◽  
Vol 10 (10) ◽  
pp. 3962
Author(s):  
Catarina J. Nascimento ◽  
Mariana Veiga ◽  
Ana Rita Silva ◽  
Joana Cominho
Keyword(s):  
Twin Pregnancy ◽  
Hydatidiform Mole ◽  
Healthy Woman ◽  
Clinical Approach ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Consensus Protocol ◽  
Rare Presentation ◽  
Normal Fetus ◽  
Increased Risk

A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.

Malignant Evolution in a Short Period of Time in a Patient of Partial Hydatidiform Mole

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Ritu Mehta ◽  
Rashmi Yadav ◽  
Vikas Chauhan ◽  
Mili Choudhary
Keyword(s):  
Hydatidiform Mole ◽  
Partial Hydatidiform Mole ◽  
Short Period

Diagnostic Utility of Microsatellite Genotyping for Molar Pregnancy Testing

2013 ◽  
Vol 137 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Larissa V. Furtado ◽  
Christian N. Paxton ◽  
Mohamed A. Jama ◽  
Sheryl R. Tripp ◽  
Andrew R. Wilson ◽  
...  
Keyword(s):  
Tandem Repeats ◽  
Hydatidiform Mole ◽  
Molar Pregnancy ◽  
Microsatellite Genotyping ◽  
Complete Hydatidiform Mole ◽  
Dna Microsatellites ◽  
Partial Hydatidiform Mole ◽  
Str Markers ◽  
Genetic Abnormalities ◽  
Pregnancy Testing

Context.—Molecular genotyping by analysis of DNA microsatellites, also known as short tandem repeats (STRs), is an established method for diagnosing and classifying hydatidiform mole. Distinction of both complete hydatidiform mole and partial hydatidiform mole from nonmolar specimens is relevant for clinical management owing to differences in risk for persistent gestational trophoblastic disease. Objective.—To determine the technical performance of microsatellite genotyping by using a commercially available multiplex assay, and to describe the application of additional methods to confirm other genetic abnormalities detected by the genotyping assay. Design.—Microsatellite genotyping data on 102 cases referred for molar pregnancy testing are presented. A separate panel of mini STR markers, flow cytometry, fluorescence in situ hybridization, and p57 immunohistochemistry were used to characterize cases with other incidental genetic abnormalities. Results.—Forty-eight cases were classified as hydatidiform mole (31, complete hydatidiform mole; 17, partial hydatidiform mole). Genotyping also revealed 11 cases of suspected trisomy and 1 case of androgenetic/biparental mosaicism. Trisomy for selected chromosomes (13, 16, 18, and 21) was confirmed in all cases by using a panel of mini STR markers. Conclusions.—This series illustrates the utility of microsatellite genotyping as a stand-alone method for accurate classification of hydatidiform mole. Other genetic abnormalities may be detected by genotyping; confirmation of the suspected abnormality requires additional testing.

scholarly journals Expression of Pro-Apoptotic Bax and Anti-Apoptotic Bcl-2 Proteins in Hydatidiform Moles and Placentas With Hydropic Changes

2019 ◽  
Author(s):  
Alireza Khooei ◽  
Fatemeh Atabaki Pasdar ◽  
Alireza Fazel ◽  
Mahmoud Mahmoudi ◽  
Mohammad Reza Nikravesh ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Tool ◽  
Stromal Cells ◽  
Hydatidiform Mole ◽  
Complete Hydatidiform Mole ◽  
Tissue Samples ◽  
Partial Hydatidiform Mole ◽  
Significant Difference ◽  
Hydropic Abortion ◽  
Hydatidiform Moles

Abstract- Morphologic examination still forms the main diagnostic tool in the differential diagnosis of molar placentas. However the criteria are subjective and show considerable inter-observer variability among pathologists. The aim of the present study was to investigate the role of Bcl-2 and Bax immunostaining in the differential diagnosis of molar placentas. Bax and Bcl-2 immunohistochemical staining were performed in 19 molars (8 partial and 11 complete hydatidiform mole) and 10 non-molar (hydropic abortion) formalin-fixed, paraffin-embedded tissue samples. Ploidy analysis using flow cytometry had confirmed diploidy in hydropic abortions and complete hydatidiform moles and triploidy in partial hydatidiform moles. Bcl-2 expression was observed only in syncytiotrophoblasts, No immunoreactivity was detected in Cytotrophoblasts, and stromal cells, the total score averages of Bcl-2 immunoexpression in partial hydatidiform moles and hydropic abortions were significantly higher than in complete hydatidiform moles, whereas no significant difference was observed between partial hydatidiform moles and hydropic abortions. Bax immunoreactivity was observed in cytotrophoblasts, stromal cells and occasionally in syncytiotrophoblasts. No statistically significant difference in Bax immunoexpression total score was observed among various groups. Based on the results of this study, Bcl-2 immunostaining offers a potential adjunctive diagnostic tool to distinguish complete hydatidiform mole from partial hydatidiform mole and hydropic abortion, but not partial hydatidiform mole from hydropic abortion, Bax immunostaining cannot be helpful in this regard.

scholarly journals Centralized surveillance of hydatidiform mole: 7-year experience from a regional hospital in China

2021 ◽  
pp. ijgc-2021-002797
Author(s):  
Lanzhou Jiao ◽  
Yaping Wang ◽  
Jiyong Jiang ◽  
Xiuying Wang ◽  
Wenqing Zhang ◽  
...  
Keyword(s):  
High Risk ◽  
Hydatidiform Mole ◽  
Single Agent ◽  
Regional Hospital ◽  
Low Risk ◽  
Gestational Trophoblastic Neoplasia ◽  
Complete Hydatidiform Mole ◽  
Gynecology And Obstetrics ◽  
Prophylactic Chemotherapy ◽  
Hydatidiform Moles

ObjectiveTo assess the strategy and value of centralized surveillance of hydatidiform mole at a regional hospital in China and to investigate the necessity of prophylactic chemotherapy for high-risk complete hydatidiform mole.MethodsBetween February 2013 and February 2020, all women with hydatidiform mole in Dalian Women’s and Children’s Medical Center (Group) were registered for surveillance and treatment when indicated. Women with complete hydatidiform mole were categorized into low-risk and high-risk groups according to the criteria from Song Hongzhao’s trophoblastic neoplasia. Outcomes and treatments were analyzed retrospectively.ResultsIn total, 703 women with hydatidiform mole were registered for surveillance with a follow-up rate of 97.9% (688/703). 680 women were enrolled and 52 (7.6%) developed post-molar gestational trophoblastic neoplasia, all with low-risk International Federation of Gynecology and Obstetrics (FIGO) scores 0–5. Post-molar gestational trophoblastic neoplasia was diagnosed in 12.3% (51/413) of patients with complete hydatidiform moles and 0.4% (1/263) of patients were diagnosed with partial hydatidiform moles (χ2=32.415, p<0.001). Post-molar gestational trophoblastic neoplasia was diagnosed in 27.7% (28/101) of the high-risk complete hydatidiform mole group and in 7.4% (23/312) of the low-risk complete hydatidiform mole group (χ2=29.196, p<0.001). No difference in the pre-treatment assessments of patients with post-molar gestational trophoblastic neoplasia was found between the low-risk and high-risk complete hydatidiform mole groups (all p>0.05). All 52 patients with post-molar gestational trophoblastic neoplasia were cured, with a complete response rate of 61.2% (30/49) with first-line single-agent chemotherapy.ConclusionsA centralized hydatidiform mole surveillance program is feasible and effective and may improve the prognosis of patients with post-molar gestational trophoblastic neoplasia. Prophylactic chemotherapy is not recommended for women with high-risk complete hydatidiform mole with adequate surveillance.

Complete Hydatidiform Mole and Coexisting Fetus With Gastroschisis: A Case Report Highlighting the Importance of Diagnostic Genotyping

2021 ◽  
pp. 109352662110248
Author(s):  
Austin McHenry ◽  
Urania Magriples ◽  
Pei Hui ◽  
Raffaella Morotti
Keyword(s):  
Differential Diagnosis ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Diagnostic Process ◽  
Rare Occurrence ◽  
Complete Hydatidiform Mole ◽  
Trophoblastic Disease ◽  
Increased Risk ◽  
Ancillary Studies

Twin pregnancy with a complete hydatidiform mole and a coexisting fetus (CHMCF) is an extremely rare occurrence, described only by a handful of published series and cases reports. The majority of the literature on CHMCF examines prenatal care and follow-up in relation to the increased risk of gestational trophoblastic neoplasia (GTN). At present, few reports elaborate on the diagnostic process and differential diagnosis, especially in the context of recent molecular advances in risk stratification for GTN. Here, we describe the first known case of a CHMCF with gastroschisis with liveborn delivery at 35 weeks gestation. This report aims to review the pre- and postnatal differential diagnosis and discuss recent updates on the importance of ancillary studies in the diagnosis of gestational trophoblastic disease.

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