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

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.

Changing Trends in the Clinical Presentation and Management of Complete Hydatidiform Mole Among Brazilian Women

2016 ◽  
Vol 26 (5) ◽  
pp. 984-990 ◽  
Author(s):  
Antonio Braga ◽  
Valéria Moraes ◽  
Izildinha Maestá ◽  
Joffre Amim Júnior ◽  
Jorge de Rezende-Filho ◽  
...  
Keyword(s):  
Natural History ◽  
Early Diagnosis ◽  
Clinical Symptoms ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Gestational Trophoblastic Neoplasia ◽  
Complete Hydatidiform Mole ◽  
Trophoblastic Disease ◽  
History Of

ObjectiveThe aim of the study was to evaluate potential changes in the clinical, diagnostic, and therapeutic parameters of complete hydatidiform mole in the last 25 years in Brazil.MethodsA retrospective cohort study was conducted involving the analysis of 2163 medical records of patients diagnosed with complete hydatidiform mole who received treatment at the Rio de Janeiro Reference Center for Gestational Trophoblastic Disease between January 1988 and December 2012. For the statistical analysis of the natural history of the patients with complete molar pregnancies, time series were evaluated using the Cox-Stuart test and adjusted by linear regression models.ResultsA downward linear temporal trend was observed for gestational age of complete hydatidiform mole at diagnosis, which is also reflected in the reduced occurrence of vaginal bleeding, hyperemesis and pre-eclampsia. We also observed an increase in the use of uterine vacuum aspiration to treat molar pregnancy. Although the duration of postmolar follow-up was found to decline, this was not accompanied by any alteration in the time to remission of the disease or its progression to gestational trophoblastic neoplasia.ConclusionsEarly diagnosis of complete hydatidiform mole has altered the natural history of molar pregnancy, especially with a reduction in classical clinical symptoms. However, early diagnosis has not resulted in a reduction in the development of gestational trophoblastic neoplasia, a dilemma that still challenges professionals working with gestational trophoblastic disease.

scholarly journals Repetitive Complete Molar Pregnancy in a 54-Year-Old Patient in a Time Distance of Eighteen Years from the First Incident: Case Report and Mini Review

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Polychronis Oikonomidis ◽  
Basileios Pergialiotis ◽  
Elina Pitsouni ◽  
Stavros Natsis ◽  
Antonios Lagkadas ◽  
...  
Keyword(s):  
Hydatidiform Mole ◽  
Abdominal Hysterectomy ◽  
Molar Pregnancy ◽  
Pelvic Ultrasound ◽  
Complete Hydatidiform Mole ◽  
Incident Case ◽  
Ultrasound Evaluation ◽  
Beta Human Chorionic Gonadotropin ◽  
History Of ◽  
Time Distance

We report a case of complete hydatidiform mole in a 54-year-old patient referred to Gynecology department of General Hospital of Athens “Laiko”, with history of previous molar pregnancy at the age of thirty-six. Our purpose was to indicate the advanced maternal age beside the long recurrence distance of the disease, which was eighteen years after the first molar pregnancy. Our diagnostic approach was through measurement of serum beta-human chorionic gonadotropin (β-HCG) and pelvic ultrasound evaluation, and the chosen therapeutic approach was abdominal hysterectomy and bilateral salpingoophorectomy.

scholarly journals A review on gestational trophoblastic disease

2016 ◽  
Vol 44 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Shirin Akter Begum ◽  
Md Zillur Rahman Bhuiyan ◽  
Rehana Akhter ◽  
Romena Afroz ◽  
Afroza Khanom ◽  
...  
Keyword(s):  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
The Body ◽  
Molar Pregnancy ◽  
Foetal Tissue ◽  
Placental Site ◽  
Abnormal Cells ◽  
Caucasian Women ◽  
Invasive Mole ◽  
The Uk

Molar pregnancy occurs when the fertilization of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. This condition is one of a group of conditions known as gestational trophoblastic tumours (GTTs). Molar pregnancies used to be called hydatidiform mole but now most people call them molar pregnancies. Molar pregnancies are rare but they are the most common type of gestational trophoblastic tumour. In the UK, about 1 in 590 pregnancies is a molar pregnancy. In Asian women, molar pregnancies are about twice as common as in Caucasian women. Most molar pregnancies are benign. They can spread beyond the womb in some women, but are still curable. Molar pregnancies can either be complete or partial. In case of complete mole, no parts of foetal tissue are formed. In case of partial mole there may be some foetal tissue in the womb, alongside the molar tissue. By measuring the levels of ?hCG in blood and urine in high dilution helps to diagnose a molar pregnancy; an ultrasound scan can also diagnose many women with molar pregnancy. The molar tissue needs to be surgically removed. Afterwards, in around 10 to 15 out of 100 women, some molar tissue remains in the deeper tissues of the womb or other parts of the body. This is called a persistent gestational tumour. Invasive mole, choriocarcinoma, and placental site trophoblastic tumor (PSTT) termed as “gestational trophoblastic neoplasia” (GTN), which can progress, invade, metastasize, and lead to death if left untreated.These women need to have chemotherapy completely get rid of the abnormal cells.Bangladesh Med J. 2015 Jan; 44 (1): 51-56

scholarly journals Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
M. De Vos ◽  
M. Leunen ◽  
C. Fontaine ◽  
Ph. De Sutter
Keyword(s):  
Surgical Treatment ◽  
Complete Remission ◽  
Treatment Option ◽  
Hydatidiform Mole ◽  
Uterine Fibroids ◽  
Treatment Method ◽  
Primary Treatment ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Hydatidiform Moles

Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment.Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission.Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.

scholarly journals Tendency to Ingest Foreign Bodies in Mentally Retarded Patients: A Case with Ileal Perforation Caused by the Ingestion of a Teaspoon

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
İhsan Yıldız ◽  
Yavuz Savaş Koca ◽  
Gökhan Avşar ◽  
İbrahim Barut
Keyword(s):  
Mental Retardation ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Mentally Retarded ◽  
The Body ◽  
Foreign Body Ingestion ◽  
Emergency Laparotomy ◽  
Ileal Perforation ◽  
History Of ◽  
The Right

Introduction. Unintentional foreign body ingestion commonly occurs accidentally in children aged between 3 months and 6 years and at advanced ages or results from psychiatric disorders such as hallucination in patients with mental retardation. Most of the ingested foreign bodies are naturally discharged from the body but some of them may require surgical intervention.Presentation of Case. A 29-year-old mentally retarded female patient was admitted to the emergency service with a two-day history of abdominal pain, nausea, and vomiting. Physical examination revealed abdominal tenderness, defense, and rebound on palpation. Radiological examination revealed diffuse air-fluid levels and a radiopaque impression of a metal object in the right upper quadrant. The metal teaspoon causing ileal perforation was extracted by emergency laparotomy. On postoperative day 7, the patient was uneventfully discharged following a psychiatric consultation.Discussion. Foreign body ingestion can occur intentionally in children at developing ages and old-age patients, or adults and prisoners, whereas it may occur unintentionally in patients with mental retardation due to hallucination. However, repeated foreign body ingestion is very rare in individuals other than mentally retarded patients.Conclusion. Mentally retarded patients should be kept under close surveillance by surgeons and psychiatrists due to their tendency to ingest foreign bodies.

Natural history of twin pregnancy with complete hydatidiform mole and coexisting fetus

1994 ◽  
Vol 47 (1) ◽  
pp. 90-90 ◽  
Author(s):  
M.A. Steller ◽  
D.R. Genest ◽  
M.R. Bernstein ◽  
J.M. Lage ◽  
D.P. Goldstein ◽  
...  
Keyword(s):  
Natural History ◽  
Twin Pregnancy ◽  
Hydatidiform Mole ◽  
Complete Hydatidiform Mole ◽  
History Of

scholarly journals Laparoscopic hysterectomy as a treatment modality for gestational trophoblastic neoplasia - report of two cases

2021 ◽  
pp. 82-82
Author(s):  
Predrag Jokanovic ◽  
Aleksandar Rakic
Keyword(s):  
Hydatidiform Mole ◽  
Uterine Cavity ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Molar Pregnancy ◽  
Placental Site Trophoblastic Tumor ◽  
Variable Intensity ◽  
Partial Hydatidiform Mole ◽  
Trophoblastic Tumor ◽  
Placental Site

Introduction. Measurement of the serum levels of human chorionic gonadotropin?s beta isoform (bhCG) remains a crucial marker for diagnosing the GTN. Choriocarcinoma is commonly diagnosed due to extremely high levels of bhCG, but the presence of distant metastasis is not uncommon. Placental site trophoblastic tumor and epithelioid trophoblastic tumor remain some sort of an enigma because the levels of bhCG are usually low. Case report. A 44-year old patient, P2G3,was admitted to the Clinic under the suspicion of molar pregnancy, vaginal bleeding with variable intensity, and levels of bhCG of 1 837 787 mIU/mL. After two explorative curettages, bhCG saw a decline and a partial hydatidiform mole was diagnosed histopathologically. The patient was admitted to the Clinic on two occasions due to the increasing values of bhCG. Since bhCG failed to drop after two explorative curettages, hysteroscopic biopsy, one chemotherapy cycle, along with the suspicious ultrasonographic feature of metastatic GTN and the fact that the patient has refused further chemotherapy, a total laparoscopic hysterectomy was performed. Histopathological exam made the diagnosis of choriocarcinoma. A 50-year old patient, P2G4, was admitted to the Clinic under the ultrasonographic suspicion of molar pregnancy. She was complaining of pelvic discomfort and frequent urination. Initial levels of bhCG were 128 351 mIU/mL. Instrumental revision of the uterine cavity was performed and partial hydatidiform mole was diagnosed histopathologically. Because of the increasing levels of bhCG, ultrasonographical suspicion of the development of GTN in the uterine corpus, in accordance with patient?s age and the fact that she has regular menstrual cycles, total laparoscopic hysterectomy was performed, and a histopathological exam made the diagnosis of the placental site trophoblastic tumor. Conclusion. Laparoscopic hysterectomy could be a treatment of choice for the chemotherapy resistant GTNs but also for the choricarcinoma in patitent?s who have finished their reproductive activity and refuse to be treated with chemotherapeutics.

Histopathological Diagnosis of Partial and Complete Hydatidiform Mole in the First Trimester of Pregnancy

2003 ◽  
Vol 6 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Neil J. Sebire ◽  
Rosemary A. Fisher ◽  
Helene C. Rees
Keyword(s):  
Early Pregnancy ◽  
Hydatidiform Mole ◽  
First Trimester ◽  
Histopathological Diagnosis ◽  
Molar Pregnancy ◽  
Diagnostic Problem ◽  
Complete Hydatidiform Mole ◽  
Products Of Conception ◽  
Genetic Abnormalities ◽  
First Trimester Of Pregnancy

The diagnosis of molar pregnancy is a continuing diagnostic problem for many practicing histopathologists who are required to examine specimens of products of conception, particularly since changes in gynecological management in recent years have resulted in uterine evacuation at earlier gestations. The aim of this review is to provide practical, up-to-date, diagnostically useful information regarding the histological diagnosis of molar disease in early pregnancy. Pathophysiological issues relevant to molar pregnancies, such as genetic abnormalities, will be briefly summarized, but nonhistopathological aspects of molar disease will not be covered in detail in this review.

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