Hydatidiform mole

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[edit] Discussion

  • Hydatidiform mole is a common complication of gestation, occurring in one of every 1,000- 2,000 pregnancies.
  • These moles can occur in a pregnant woman of any age, but the rate of occurrence is higher in pregnant women in their teens or between the ages of 40 and 50 years.
  • In the classic case of molar pregnancy, quantitative analysis of HCG shows hormone levels in both blood and urine greatly exceeding those produced in a normal pregnancy at the same stage.

  • The absence or presence of a fetus or embryo has been used to distinguish complete moles from partial moles.
    • Complete moles are associated with the absence of a fetus
    • Partial moles usually occur with an abnormal fetus or may even be associated with fetal demise.
  • Moles rarely coexist with a normal pregnancy, in which a normal fetus and placenta are seen separate from the molar gestation.

  • Ninety percent of complete hydatidiform moles have a 46,XX diploid chromosomal pattern. All the chromosomes are derived from the sperm, suggesting fertilization of a single egg that has lost its chromosomes.
  • With partial moles, the karyotype is usually triploid (69,XXY): the result of fertilization of a normal egg by two sperm, one bearing a 23,X chromosomal pattern and the other a 23,Y chromosomal pattern.

  • Complete hydatidiform moles usually occupy the uterine cavity and are rarely located in fallopian tubes or ovaries.
  • The chorionic villi are converted into a mass of clear vesicles that resemble a cluster of grapes.

[edit] Imaging Findings

[edit] Ultrasound

  • Complete hydatidiform mole has a classic sonographic appearance of a solid collection of echoes with numerous anechoic spaces (snowstorm appearance).
  • In partial moles, the placenta is enlarged and contains areas of multiple, diffuse anechoic lesions.

[edit] CT

  • A CT scan usually demonstrates a normal-sized uterus with areas of low attenuation, an enlarged inhomogeneous uterus with a central area of low attenuation, or hypoattenuating foci surrounded by highly enhanced areas in the myometrium.

[edit] Images

Patient #1: Complete mole

[edit] See Also

[edit] External Links

[edit] References