Sep 30, 2015 the hydatidiform mole hm is a placental pathology of androgenetic origin. Gestational trophoblastic diseases gtd include hydatidiform moles both complete and partial, invasive moles, and choriocarcinoma. Gestational trophoblastic disease includes hydatidiform mole. The placenta is the organ that develops during pregnancy to feed the fetus. Hydatidiform mole an overview sciencedirect topics. Hydatidiform mole is a pathologic conceptus characterized by marked enlargement of the placental villi.
The incidence is higher toward the beginning and more toward the end of the childbearing period. Hydatidiform moles are abnormal conceptions, which occur in about. Gestational trophoblastic disease gtd is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. The early teens and the perimenopause years are most at risk. However, a malignancy called choriocarcinoma may start from a hydatidiform mole. Hydatidiform moles are benign, whereas invasive moles and choriocarcinoma are malignant lesions with a tendency to metastasize to other organs. 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 gestational trophoblastic disease which grows into a mass in the uterus that has swollen chorionic villi. Gtd refers to both the benign and malignant entities in the spectrum and includes hydatidiform mole complete and partial, invasive mole, choriocarcinoma, placental site trophoblastic tumor pstt, and epithelioid.
These hydatidiform moles belong to the gestational trophoblastic diseases of which represent the most common pathologies. 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. This grapelike mass forms inside of the uterus after fertilization instead of a. Hm, or molar pregnancy, results from abnormal fertilization of the oocyte egg. A tumor that forms in the uterus as a mass of cysts resembling a bunch of grapes. Risk of partial and complete hydatidiform molar pregnancy in. Age and a previous molar pregnancy affect the risk of gtd.
This lesion has been known as chorioadenoma destruens, penetrating mole, malignant mole. Gestatinal pathology hydatidiform mole flashcards quizlet. Gestational trophoblastic disease encompasses a range of pregnancyrelated disorders, consisting of the premalignant disorders of complete and partial hydatidiform mole, and the malignant. Gestational trophoblastic disease includes hydatidiform mole complete and partial and gestational trophoblastic neoplasia invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The placenta grows normally with little or no growth of. After evacuation of a hydatidiform mole, followup is essential to detect trophoblastic sequelae invasive mole and choriocarcinoma, which develop in approximately 15% to 20% of patients with complete mole and 1% to 5% with partial mole. In its early stages, a hydatidiform mole may look like a normal pregnancy. 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. To learn more about learning in 10 lit, please visit. Hydatidiform mole is the most common form of gtn see the image below.
The epidemiology, pathology, clinical presentation, and diagnosis of each of these trophoblastic disease variants. Complete moles carry higher risk of malignancy than partial moles. In 1827, velpeau and boivin first recognized hydatids as cystic dilations of chorionic villi but it was not until 1895 that marchand described the proliferation of the. A hydatidiform mole is part of a group of disorders called gestational trophoblastic disease gtd. Hydatidiform mole is a disease of pregnancy, and therefore a disease of women. A molar pregnancy is a rare complication that happens when tissue inside the uterus becomes a mass or tumor. Because the embryo does not form or is malformed in molar pregnancies, and because there is a small risk of developing a. A molar pregnancy is very uncommon affecting around 1 in 1,200 pregnancies. In instances of a partial mole, two sperms might fertilize a single ovum.
It is the benign kind of gestational trophoblastic disease gtd while the cancerous kind is invasive mole, epithelioid trophoblastic tumor, choriocarcinoma and placental. Nov 01, 2016 a hydatidiform mole is part of a group of disorders called gestational trophoblastic disease gtd. With this condition, the embryo fails to develop beyond a primitive start. Overview and pathophysiology of gestational trophoblastic. Placental villi have an abnormal hyperproliferation event and hydropic degeneration. The following discussion is limited to hydatidiform moles complete and partial. Hydatidiform vesicular mole it is a benign neoplasm of the chorionic villi. In a complete molar pregnancy, the placental tissue. It may also be diagnosed after a miscarriage, when the tissue that is collected or passed from the uterus is examined. The symptoms of molar pregnancy, which may include vaginal bleeding, severe morning sickness, stomach cramps, and high blood pressure, typically begin around the 10th week of pregnancy. Hydatidiform mole definition of hydatidiform mole by. Webmd explains what the symptoms are and how its diagnosed and treated. May 15, 2010 hydatidiform vesicular mole it is a benign neoplasm of the chorionic villi. Overrepresentation of the paternal genome in sporadic hydatidiform moles purely androgenetic in complete hydatidiform moles and diandric triploid in partial hydatidiform moles.
For unknown reasons, the incidence of moles varies by race 9. 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. Start studying gestatinal pathology hydatidiform mole. Choriocarcinoma a type of cancer hydatiform mole also called a molar pregnancy bouchardfortier g, covens a. When a hydatidiform mole invades the myometrium and broad ligament, or it is found in distant sites as vagina, vulva, and lung, it is referred as invasive mole. Hydatidiform mole occurs at present in approximately 1 in 2000 pregnancies in europe and the united states, but the rate approaches 1 in 500 in japan, singapore and malaysia 3,9. Feb 16, 2018 hydatidiform mole is a disease of pregnancy and therefore a disease of women. Feb 16, 2018 gestational trophoblastic neoplasia gtn is a collective term for gestational trophoblastic diseases that invade locally or metastasize. However, there is a risk that a hydatidiform mole can develop into a cancerous malignant type of gtd, known as gestational trophoblastic neoplasia gtn. Hydatidiform mole symptoms, diagnosis, treatments and.
Since that time, hm also referred to as molar pregnancy or mole has been of clinical and research interest. Hydatidiform mole approximately 20% of patients with primary hydatidiform mole develop persistent gtd invasive mole, choriocarcinoma, placental site trophoblastic tumor. The abnormal cells start in the tissue that would normally become the placenta. Hydatidiform moles occur during the childbearing years, and they do not spread outside the uterus. It is of clinical and epidemiological interest because of its significant complication in. Gestational trophoblastic disease gynecology and obstetrics. Partial and complete hydatidiform moles are benign not cancerous forms of gtd. Hydatidiform mole hm is a rare mass or growth that forms inside the womb uterus at the beginning of a pregnancy. Circumferential proliferation of villous trophoblast with villous edema image 2.
Jan 29, 2019 gestational trophoblastic disease gtd lesions characterized by abnormal proliferation of trophoblast of the placenta. Women in their early teenage or perimenopausal years are most at risk. 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. They typically arise from the abnormal fertilization of the ovum. The mole, a collection of sacs cysts containing a jellylike substance, resembles clusters of. This is a learning in 10 voice annotated presentation vap on hydatidiform mole. 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. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Uterus expands in normal pregnancy uterus is much larger and.
Circumferential proliferation of trophoblast with cellular atypia image 3. Hydatidiform moles are benign, whereas invasive moles and choriocarcinoma are malignant lesions with a tendency to metastasize to other organs, especially the lungs. The disorder occurs when hydropic chorionic villi are present within the myometrium, its vascular spaces, or at distant sites. Genetic, ovular, or nutritional abnormalities could possibility be responsible for trophoblastic disease. This category is comprised of benign, nonneoplastic lesions, including placental site nodule, exaggerated placental site, and hydatidiform mole. 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. This disease can occur during or after an intrauterine or ectopic pregnancy.
Partial mole and triploidy 64 of 832 specimens triploid 8% 23 are diandric half, or total were partial moles most of the remainder showed some but not all features of a partial mole. Hydatidiform mole hm is the most common type of gtd. It is a type of gestational trophoblastic disease gtd. There are two types of molar pregnancy, complete molar pregnancy and partial molar pregnancy. Hydatidiform mole is a disease of pregnancy and therefore a disease of women. As the cells degenerate, they become filled with fluid and appear as clear fluid, grapesized vesicles.
Includes complete hydatidiform mole, partial hydatidiform mole, and invasive mole. Sep 12, 2012 invasive mole invasive mole is the most common sequela of hydatidiform mole, representing 70% to 90% of cases of persistent gtd. William smelie was the first to use the term hydatidiform mole in 1752 to describe the bunch of grapes of different sizes typical of this placental pathology. 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 about 11 4. The hydatidiform mole hm is a placental pathology of androgenetic origin. Gestational trophoblastic disease gtd is a group of pregnancyrelated conditions that develop inside a womans uterus womb. Mole hydatidiform mole gestational trophoblastic disease is abnormal proliferation and degeneration of the trophoblasitic villi. Pdf new insights in the pathophysiology of complete hydatidiform.
Malignant transformation set apart by failure of serum beta human chorionic gonadotropin to return to normal levels after treatment of the mole. Sep 18, 2016 this is a learning in 10 voice annotated presentation vap on hydatidiform mole. Molar pregnancy, partial and complete hydatidiform mole presented by usmle ace, inc. 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. Molar pregnancy is a condition in which the placenta does not develop properly. Hydatidiform mole genetic and rare diseases information. 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. The term gestational trophoblastic disease gtd encompasses a spectrum of tumors with a wide range of biologic behavior and potential for distant metastases. Abnormal conception characterized by swollen and edamatous villi with profileration of trophoblasts 2. 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 was first described by hippocrates around 400 b.
This condition may also be called a hydatidiform mole or gestational trophoblastic tumour. New insights in the pathophysiology of complete hydatidiform mole. Since that time, hm also referred to as molar pregnancy. Overview and pathophysiology of gestational trophoblastic disease presentation free ebook download as powerpoint presentation. Gestational trophoblastic disease is the degeneration and abnormal proliferation of the trophoblastic villi. Signs of gtd include abnormal vaginal bleeding and a uterus that is larger than normal. In the situation in which the hydatidiform mole develops, the embryo is usually either absent or dead. A hydatidiform mole is a placental tumor that develops after pregnancy has occurred.
Gestational trophoblastic disease hydatidiform mole rnpedia. Categorized as complete or partial based on gross characteristics, histologic findings, karyotype 3. A rare condition where an abnormal union between an egg and a sperm results in the formation of grapelike cysts instead of a baby. A baby may or may not develop during these types of pregnancies. In early complete mole the degree of villous trophoblastic hyperplasia may not be prominent. Hydatidiform mole symptoms, diagnosis, treatments and causes. The cells become filled with clear fluid, giving them the appearance of grapelike vesicles. Hydatidiform mole molar pregnancy is the premalignant form of gestational trophoblastic neoplasia. More detailed information about the symptoms, causes, and treatments of hydatidiform mole is available below symptoms of hydatidiform mole. Read more about symptoms, diagnosis, treatment, complications, causes and. Hydatidiform mole is an abnormal placenta characterized by enlarged, edematous and vesicular chorionic villi accompanied by villous trophoblastic hyperplasia frequency of hydatidiform moles is higher in asia and middle east 100 100,000 pregnancies compared to north america and europe 100 per 100,000 pregnancies lancet oncol 2003.
Circumferential proliferation of trophoblast with villous edema. It is sometimes detected when you have an early pregnancy ultrasound. There are two, genetically related, types of abnormal placental morphogenesis known as complete and partial hydatidiform moles. A molar pregnancy can develop when a fertilized egg does not contain an. Overview and pathophysiology of gestational trophoblastic disease presentation. Hydatidiform mole is more common at the extremes of reproductive age. 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. Gestational trophoblastic disease knowledge for medical. 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. Gestational trophoblastic disease gtd lesions characterized by abnormal proliferation of trophoblast of the placenta. The majority of complete hydatidiform moles chm are detected on ultrasound examination by the end of the first trimester. The pathogenesis of gtd is unique because the maternal tumor arises from gestational rather than maternal tissue 1. Gestational trophoblastic disease hydatidiform mole. Complete moles show no evidence of a fetus on ultrasonography.
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