Malignant transformation set apart by failure of serum beta human chorionic gonadotropin to return to normal levels after treatment of the mole. Since that time, hm also referred to as molar pregnancy or mole has been of clinical and research interest. Human chorionic gonadotropin and thyroid function in patients with hydatidiform mole. Molar pregnancy, partial and complete hydatidiform mole presented by usmle ace, inc. A hydatidiform mole may be either complete or partial. A hydatidiform mole is a growing mass of tissue inside the womb uterus that will not develop into a baby. Gestational trophoblastic disease hydatidiform mole. Hmole gestational trophoblastic disease is abnormal proliferation and degeneration of the trophoblastic villi. This is an ovum not carrying any chromosomes or genetic material. Gestational trophoblastic diseases gtd include hydatidiform moles both complete and partial, invasive moles, and choriocarcinoma. The following discussion is limited to hydatidiform moles complete and partial. Gestational trophoblastic disease hydatidiform mole rnpedia.
Trophoblasts infiltrate the myometrium and gain access to the vascular system. New insights in the pathophysiology of complete hydatidiform mole. The following discussion will be limited to hydatidiform moles, complete and partial. Hydatidiform mole genetic and rare diseases information. As the cells degenerate, they become filled with fluid and appear as clear fluid, grapesized vesicles. Nov 01, 2016 a hydatidiform mole is a growing mass of tissue inside the womb uterus that will not develop into a baby. Hm, or molar pregnancy, results from abnormal fertilization of the oocyte egg. Complete hydatidiform moles chm are abnormal pregnancies with no fetal development resulting from having two paternal genomes with no maternal contribution. Hydatidiform mole is the most common form of gtn see the image below. A hydatidiform mole is a placental tumor that develops after pregnancy has occurred. They typically arise from gestational trophoblastic disease knowledge for medical students and physicians. These hydatidiform moles belong to the gestational trophoblastic diseases of which represent the most common pathologies. Patients with evidence of marked trophoblastic growth such as preevacuation hcg level of 100,000 miuml, excessive uterine growth 20 week size and theca lutein cysts 6 cm in diameter have 40% incidence of postmolar gestational trophoblastic disease, compared to 4% for those without any of these signs. Hydatidiform moles are abnormal conceptions, which.
The pathogenesis of gtd is unique because the maternal tumor arises from gestational rather than maternal tissue 1. Hydatidiform mole definition of hydatidiform mole by. Hydatidiform vesicular mole it is a benign neoplasm of the chorionic villi. Learn vocabulary, terms, and more with flashcards, games, and other study tools. A molar pregnancy is a gestational trophoblastic disease which grows into a mass in the uterus that has swollen chorionic villi. All detected moles were complete hydatidiform moles, and there were no diagnosed partial hydatidiform moles. Request pdf new insights in the pathophysiology of complete hydatidiform mole objective. Gestational trophoblastic diseasepatient version national. Genetic, ovular, or nutritional abnormalities could possibility be responsible for trophoblastic disease. Includes complete hydatidiform mole, partial hydatidiform mole, and invasive mole. Almost all women with malignant gestational trophoblastic disease can be cured with preservation of reproductive function.
May 15, 2010 hydatidiform vesicular mole it is a benign neoplasm of the chorionic villi. A baby may or may not develop during these types of pregnancies. Invasive mole invasive mole is the most common sequela of hydatidiform mole, representing 70% to 90% of cases of persistent gtd. The cells become filled with clear fluid, giving them the appearance of grapelike vesicles. With this condition, the embryo fails to develop beyond a primitive start. Hydatidiform mole is listed as a rare disease by the office of rare diseases ord of the national institutes of health nih. Complete moles carry higher risk of malignancy than partial moles.
Hydatidiform mole is more common at the extremes of reproductive age. Molecular genetic studies of complete hydatidiform moles. The disorder occurs when hydropic chorionic villi are present within the myometrium, its vascular spaces, or at distant sites. Hydatidiform mole, in human pregnancy, abnormal growth of the chorion, the outermost vascular membrane that in a normal pregnancy would enclose the embryo and ultimately give rise to the placenta.
Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Gestational trophoblastic disease gynecology and obstetrics. Molar pregnancy is an abnormal form of pregnancy in which a nonviable fertilized egg. In the situation in which the hydatidiform mole develops, the embryo is usually either absent or dead. Clinical and cytogenetic comparison of hydatidiform moles and hydropic abortus. The majority of complete hydatidiform moles chm are detected on ultrasound examination by the end of. A molar pregnancy also known as hydatidiform mole is a rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta. Hydatidiform mole an overview sciencedirect topics. Explore the links on this page to learn more about gtd treatment and clinical trials.
It is sometimes detected when you have an early pregnancy ultrasound. The incidence is higher toward the beginning and more toward the end of the childbearing period. This category is comprised of benign, nonneoplastic lesions, including placental site nodule, exaggerated placental site, and hydatidiform mole. Vassilakos department of pathology, university medical centre, 1211 geneva 4, switzerland. Read more about symptoms, diagnosis, treatment, complications, causes and.
Placental villi have an abnormal hyperproliferation event and hydropic degeneration. Hydatidiform mole proliferates within the uterus without myometrial infiltration or hematogenic dissemination. Rarely, a hydatidiform mole develops when there is a living fetus. The majority of complete hydatidiform moles chm are detected on ultrasound examination by the end of the first trimester when they present as multiple sonolucent cysts. Hydatidiform mole molar pregnancy is the premalignant form of gestational trophoblastic neoplasia. It is important to distinguish chm from partial hydatidiform moles, and nonmolar abortuses, due to the increased risk of gestational trophoblastic neoplasia. It is of clinical and epidemiological interest because of its significant complication in pregnancy. Hydatidiform mole is an abnormal pregnancy characterized by varying degrees of trophoblastic proliferation both cytotrophoblast and syncytiotrophoblast and vesicular swelling of placental villi associated with an absent or abnormal fetusembryo. Since that time, hm also referred to as molar pregnancy. This means that hydatidiform mole, or a subtype of hydatidiform mole, affects less than 200,000 people in the us population. However, a hydatidiform mole can develop from cells that remain in the uterus after a miscarriage, a fullterm pregnancy, or a mislocated pregnancy ectopic pregnancy. Hydatidiform moles and choriocarcinoma arise from villous trophoblast and placentalsite trophoblastic tumors from interstitial trophoblast.
To better understand the pathophysiology of this unique placental pathology. Overrepresentation of the paternal genome in sporadic hydatidiform moles purely androgenetic in complete hydatidiform moles and diandric triploid in partial hydatidiform moles. Sep 18, 2016 this is a learning in 10 voice annotated presentation vap on hydatidiform mole. Risk of partial mole was 11 cases per 10,000 live births gynecol oncol 2016. Start studying gestatinal pathology hydatidiform mole. Hydatidiform mole symptoms, diagnosis, treatments and causes. Hydatidiform mole hm is a genetically abnormal pregnancy with malignant potential, which exists in two forms, complete chm and partial hydatidform mole phm. Complete hydatidiform mole radiology reference article.
Hydatidiform mole is a pathologic conceptus characterized by marked enlargement of the placental villi. Hydatidiform mole hm was first described by hippocrates around 400 b. There are two types of molar pregnancy, complete molar pregnancy and partial molar pregnancy. Gestational trophoblastic disease gtd lesions characterized by abnormal proliferation of trophoblast of the placenta. Molar pregnancy is an abnormal form of pregnancy in which a nonviable fertilized egg implants in the uterus and will fail to come to term. For unknown reasons, the incidence of moles varies by race 9. It is a type of gestational trophoblastic disease gtd. A partial hydatidiform mole is a completely independent ailment to complete hydatidiform mole. A hydatidiform mole is usually harmless, however it can keep growing and, if left untreated, can bury itself into the organs around it, including the uterus womb and even spread via the blood to other distant organs including the lungs, liver or brain. A molar pregnancy is a rare complication that happens when tissue inside the uterus becomes a mass or tumor. Just remember that if it is complete it is an empty ovum meaning there is an abnormal. Webmd explains what the symptoms are and how its diagnosed and treated. A hydatidiform mole is usually harmless, however it can keep growing and, if left untreated, can bury itself into the organs around it, including the uterus womb and even spread via the blood to. Hydatidiform mole hm is a rare mass or growth that forms inside the womb uterus at the beginning of a pregnancy.
Sep 30, 2015 the hydatidiform mole hm is a placental pathology of androgenetic origin. Dec 14, 2017 a molar pregnancy also known as hydatidiform mole is a rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta. It is characterized by the presence of a hydatidiform mole or hydatid mole, mola hydatidosa. Hydatidiform mole hm is the most common type of gtd. Hydatidiform mole is a disease of pregnancy and therefore a disease of women. Gestatinal pathology hydatidiform mole flashcards quizlet. This grapelike mass forms inside of the uterus after fertilization instead of a.
The hydatidiform mole hm is a placental pathology of androgenetic origin. Feb 16, 2018 gestational trophoblastic neoplasia gtn is a collective term for gestational trophoblastic diseases that invade locally or metastasize. The incidence rates ir of hm show wide geographic variations, due to differences in registration practices and methods of estimating rates. Pdf revisiting the pathology of hydatidiform moles. This lesion has been known as chorioadenoma destruens, penetrating mole, malignant mole. A complete hydatidiform mole chm is a type of molar pregnancy and falls at the benign end of the spectrum of gestational trophoblastic disease. This study was to determine the incidence, risk factors. Definition a hydatidiform mole is a relatively rare condition in which tissue around a fertilized egg that normally would have developed into the placenta instead develops as an abnormal cluster of cells. Jan 29, 2019 gestational trophoblastic disease gtd lesions characterized by abnormal proliferation of trophoblast of the placenta. Pdf hydatidiform mole molar pregnancy is the premalignant form of gestational trophoblastic neoplasia. Gestational trophoblastic disease gtd is a general term for rare tumors that form from the tissues surrounding fertilized egg.
This is a learning in 10 voice annotated presentation vap on hydatidiform mole. The placenta is the organ that develops during pregnancy to feed the fetus. Clinical and imaging features1 gestational trophoblastic disease gtd is a spectrum of both benign and malignant gestational tumors, including hydatidiform mole complete and partial, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Gestational trophoblastic disease gtd is a group of pregnancyrelated conditions that develop inside a womans uterus womb. Gestational trophoblastic disease is a tumor originating from the trophoblast, which surrounds the blastocyst and develops into the chorion and amnion see page placenta and embryo at. To learn more about learning in 10 lit, please visit. May develop malignant traits and become an invasive mole 20% risk no histologic signs of malignancy in the primary tumor. Clinical presentation of complete hydatidiform mole and partial hydatidiform mole at a regional trophoblastic disease center in the united states over the past 2 decades. It may also be diagnosed after a miscarriage, when the tissue that is collected or passed from the uterus is examined. Prevalence and factors associated with hydatidiform mole among. Gestational trophoblastic disease is the degeneration and abnormal proliferation of the trophoblastic villi.
In the situation in which the hydatidiform mole develops, the embryo is usually either absent or. A molar pregnancy is very uncommon affecting around 1 in 1,200 pregnancies. The abnormal cells start in the tissue that would normally become the placenta. Complete moles show no evidence of a fetus on ultrasonography. In instances of a partial mole, two sperms might fertilize a single ovum. Hydatidiform moles are intriguing pathologic entities representing abnormal placental villous tissue with unique genetic profiles and a wide spectrum of morphologic features, which makes accurate diagnosis challenging. Hydatidiform mole partial and complete invasive mole local extension into the uterus or vagina choriocarcinoma malignancy often complicated by distant metastases placental site trophoblastic tumor. A hydatidiform mole hydatid mole, mola hydatidosa is a placental mass resulting from the proliferation of the trophoblast, with hydropic degeneration and avascularity of the chorionic villi. Women in their early teenage or perimenopausal years are most at risk. Contemporary diagnosis of hydatidiform mole charles zaloudek, md nancy joseph, md, phd department of pathology university of california san francisco the presenters have no conflicts of interest to disclose gestational trophoblastic disease hydatidiform mole invasive mole choriocarcinoma placental site trophoblastic tumor pstt. Hydatidiform mole is an aberrant human pregnancy characterized by. Epidemiology a complete hydatidiform mole is the commonest type of gestational trophoblastic dise.