Edit concept Question Editor Create issue ticket

Invasive Hydatidiform Mole

Invasive Mole


Presentation

  • Here is a case which presented with history of evacuation for molar pregnancy.[scopemed.org]
  • A bound-in CD-ROM contains all the images from the book, downloadable to PowerPoint presentations.[books.google.com]
  • Analysis of zygosity of CHMs with and without invasion at presentation, including invasive CHMs with concurrent atypical trophoblastic proliferations concerning for or consistent with choriocarcinoma, has not been specifically addressed.[journals.lww.com]
  • […] features Most common form of persistent or metastatic gestational trophoblastic disease (GTD) after hydatidiform mole; occurs 6 - 10 times more frequently than choriocarcinoma Defined as molar gestation invading myometrium or uterine vessels Commonly presents[pathologyoutlines.com]
  • The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
Heart Disease
  • Free radicals may play a part in cancer, heart disease, stroke, and other diseases of aging.[cancer.gov]

Workup

  • If malignancy is suspected, workup must include an x-ray of the chest to screen for lung metastases. Hydatidiform moles are normally treated via dilation and curettage, whereas choriocarcinoma typically requires chemotherapy.[amboss.com]
Trophoblastic Cells
  • Sheets of anaplastic trophoblastic cells are noted without the maintenance of the pattern of the villi. Extensive necrosis is evident. Back to Top[glowm.com]
  • cells in the myometrium Usually limited to uterus; secretes low levels of beta-human chorionic gonadotrophin (βhCG) Rare Epithelioid trophoblastic tumor (ETT) Chorionic-type extravillous trophoblastic cells in the chorion laeve Variant of PSTT – clinical[arupconsult.com]
  • PSTT is diploid and arises from the non-villous trophoblast and the pathology is characterised by intermediate trophoblastic cells with vacuolated cytoplasm, the expression of PLAP rather than hCG and the absence of cytotrophoblast and villi.[hmole-chorio.org.uk]
  • Then emerged the concept of prophylactic chemotherapy on the basis of following points - 1.Trophoblastic cells are highly sensitive to certain chemotherapeutic agents particularly methotrexate and actinomycin D. 2.[ispub.com]

Treatment

  • Even if disease has spread, monocytostatic treatment might be sufficient if the diagnosis has been histologically confirmed.[ncbi.nlm.nih.gov]
  • An invasive mole can be treated with an ultrasound-guided local injection of MTX in addition to the established systemic MTX treatment.[ncbi.nlm.nih.gov]
  • Abstract Seventy-six patients with invasive hydatidiform mole (HM) were reviewed as to clinical course, particularly treatment and outcome, in relation to their age.[ncbi.nlm.nih.gov]
  • The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]

Prognosis

  • Despite metastasizing GTD with poor prognosis criteria she was treated with single agent therapy. Eight cycles of two weekly methotrexate (MTX) were administered.[ncbi.nlm.nih.gov]
  • Life events and breast cancer prognosis. BMJ: British Medical Journal. 1992;304(6842):1632. McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemeroff CB, et al. Depression in patients with cancer: diagnosis, biology and treatment.[ijrcog.org]
  • Prognosis With appropriate treatment, all hydatidiform moles are curable, and nearly all cases of more aggressive molar tumors can be cured.[drugs.com]
  • Monitor β- HCG levels until in reference range (usually 8–12 weeks) Chemotherapy (usually methotrexate ) if unresolved, as indicated by any of the following: Prognosis References: [1] [2] [3] [4] [5] [6] Choriocarcinoma Definition Highly aggressive, malignant[amboss.com]
  • It might have already metastasized when it is diagnosed which carries a poorer prognosis (outlook).[cancer.org]

Etiology

  • Etiology Etiology is not known. Diagnostic methods Histologically, invasive moles are characterized by hyperplasia of trophoblasts, generalized cystic degeneration of chorionic villi and the presence of molar villi in the myometrium.[orpha.net]
  • […] an invasive mole Etiology Risk factors Prior molar pregnancy History of miscarriage Patients 15 and 35 years Complete mole Does not contain any fetal or embryonic parts Caused by fertilization of an empty egg that does not carry any chromosomes The ([amboss.com]

Epidemiology

  • Summary Epidemiology Annual incidence and prevalence are not known.[orpha.net]
  • Epidemiology of gestational trophoblastic diseases. Best Pract Res Clin Obstet Gynecol. 2003;17:837-47. Sebire NJ, Foskett RA, Fisher RA, Rees H, Seckl M, Newlands E.[ijrcog.org]
  • Gynecol Oncol. 100(3): 511–520 PubMed CrossRef Google Scholar Bagshawe KD (1992) Trophoblastic tumors: diagnostic methods, epidemiology, clinical features and management. In: Coppleson M (ed) Gynecologic oncology.[link.springer.com]
  • […] bleeding or a missed abortion Trophoblastic neoplasia (invasive mole or choriocarcinoma) follows complete mole in 15 - 20% of cases ( Am J Obstet Gynecol 1978;131:665 , J Reprod Med 1991;36:40 , J Reprod Med 1998;43:21 , Obstet Gynecol 1992;79:403 ) Epidemiology[pathologyoutlines.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Hydropic degeneration of chorionic villi with concomitant proliferation of cytotrophoblasts and syncytiotrophoblasts death of the embryo Clinical features Complete mole Vaginal bleeding during the first trimester Uterus size greater than[amboss.com]
  • Asian countries (Philippines: 1:173; India: 1:160; Taiwan: 1:125; and Indonesia: 1:82) ( Am J Obstet Gynecol 1964;90:308 , Ann N Y Acad Sci 1959;80:178 ) Extremes of age ( 20 and 40 years) and previous history of mole Dietary deficiency of vitamin A Pathophysiology[pathologyoutlines.com]
  • […] hydatidiform molar pregnancy Asian or American Indian ancestry, or (for GTN only) African ancestry Older maternal age – women 40 years Familial disease – rare, more common in recurrent CHM NLRP7 and (rarely) KHDC3L gene mutations implicated (Wang, 2009) Pathophysiology[arupconsult.com]

Prevention

  • Prevent and plan for potential complications associated with the advancing age of pregnant women.[books.google.com]
  • Aloxi listen (uh-LOK-see) A drug used to prevent nausea and vomiting caused by chemotherapy. It is also used to prevent nausea and vomiting after surgery.[cancer.gov]
  • To prevent the morbidity and mortality associated with postmolar malignant sequelae, prophylactic hysterectomy was advocated by some (5), but it could not prevent metastasis in other body parts besides sacrificing the reproductive potential in young patients[ispub.com]
  • […] histology Differential Diagnosis Partial Mole Missed abortion Choriocarcinoma Treatment Treatment involves evacuation of uterine contents by dilation and curettage Alternatively, patients who do not desire further fertility may opt for a hysterectomy to prevent[learningradiology.com]
  • Prevention Although any woman who becomes pregnant is at some risk of developing one of these uncommon conditions, the risk appears to be higher in pregnant women who are younger than age 20 or older than age 40.[drugs.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!