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Query: UMLS:C0027960 (mole)
 21,279 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Molar pregnancy should always be considered as a possible diagnosis in any pregnancy that does not conform to the normal. The practice of subjecting all pregnant women to ultrasound B-scan at their first visit in some centres is commendable, but unfortunately not possible in the areas of high incidence, owing to lack of facilities. Close, regular and meticulous follow-up with facilities for radio-immunoassay of HCG is a necessity after a mole has been treated. Early detection of lesions and individualized treatment of patients, with close monitoring of progress, are essential. Where necessary, enlightened use of drugs with adjuvant surgery and occasionally radiotherapy will give the optimum chance of recovery. To achieve complete eradication of the tumour, treatment may be required even after the HCG test appears to be negative.
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PMID:Disease of the trophoblast. 629 52

The authors report on a triploid pregnancy with foetal malformations and a sonographically diagnosed partial hydatit mole. The course of this pregnancy was characterised by pre-eclampsia. The fact that in this case, for example, HCG serum levels were very high and persisted post abortum, similar to the concentrations seen in complete hydatit mole, underlines the difficulties in assessing and diagnosing a partial hydatit mole.
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PMID:[Partial hydatidiform mole with significantly increased serum HCG levels in the triploidy syndrome]. 656 15

The production of TBG in liver increases during pregnancy. The thyroid stimulating substance is also suggested to exist in molar pregnancy. We have studied the thyroid functions with T4, T3, T3 resin uptake, TBG, free T4, TSH, HCG, TBG binding capacity and T4 binding by TBG in non-pregnant women, pregnant women and molar pregnant women. T4 and T3 levels were high during pregnancy and remarkably elevated in mole. TBG levels were 49.0 +/- 5.1/micrograms/ml in 3rd. trimester, which were 2.6 times higher than non-pregnant women and 38.4 +/- 8.4 micrograms/ml in mole. Res-O-Mat T3 values distributed within normal levels in 1st trimester and mole and higher in 3rd. trimester. Free T4 indices were almost normal during pregnancy and 2.4 times higher in mole. Free T4 levels, measured with dialysis and RIA, were slightly low during pregnancy but remarkably high in mole. Basal TSH levels were within normal range for these subjects. Beta-HCG levels in mole were greatly in excess of peak concentrations that were seen at 9-13 weeks of normal pregnancy. The significant correlations of beta-HCG with T4, T3 and free T4 index were found in mole, with coefficient of r = 0.691, 0.687, 0.644 respectively. The correlations of beta-HCG with free T4 and TBG were also suggested in mole. The levels of T4 binding by TBG were remarkably elevated for incremental TBG in mole, which pattern was particular for thyroid hyperfunction. From the above results, we considered that euthyroidism is sustained during pregnancy and thyroid stimulating substance existed in mole. That substance is probably HCG, which is remarkable elevated in mole.
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PMID:[T4, T3, T3 resin uptake, TBG and free T4 levels for thyroid functions in normal and molar pregnancy (author's transl)]. 680 12

There are at least two mechanisms of origin for complete mole, each with different genetic implications; 1) the fertilization of an empty egg by a haploid sperm and its subsequent duplication (homozygous mole), 2) the fertilization of such an egg by two haploid sperms, which produces an heterozygous constitution of allelic genes (heterozygous mole). The present study was undertaken to investigate whether the difference of origin would determine whether the moles underwent malignant transformation or not. By using of chromosomal, enzymatic and HLA polymorphisms, 35 moles were confirmed to be androgenetic in origin. Among them fifteen homozygous and 4 heterozygous moles were identified. The persistency of high HCG titration of the urine in the mother was observed in all 4 cases from the latter (4/4-100%), though the percentage of the development of sequelae in the former was low (1/15-6.7%). The diagnosis of destructive mole was established in the uterine lesion of 2 heterozygous moles by pathological examination. These two patients had lung metastases. A high incidence of sequelae after the expulsion of heterozygous moles suggests that the heterozygous constitution of allelic genes plays an important role in the process of malignant transformation of trophoblasts.
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PMID:[The propensity to malignant changes in heterozygous moles]. 715 99

An immunohistochemical study analyzing distributions of beta-subunit human chorionic gonadotropin (beta HCG), human placental lactogen (HPL), placental alkaline phosphatase (PLAP), and monoclonal anti-cytokeratin (PKK1) was undertaken to determine whether the reactivity of these antigens might assist in the differential diagnosis of molar and non-molar hydropic placentas. A total of 16 complete hydatidiform moles, 15 partial hydatidiform moles, 12 hydropic abortuses and 39 non-hydropic placentas with gestational age ranging from 4 to 40 weeks was examined. In both the complete and partial moles, many syncytiotrophoblasts stained for beta HCG, HPL, PLAP and PKK1 although the staining intensity of beta HCG in the partial moles was weak compared with the complete moles. The staining patterns in the hydropic abortuses were almost the same as those in the normal first trimester placentas and had no distinct features from the partial moles. Trophoblastic hyperplasia is an essential feature in differentiating partial moles from hydropic abortuses. With regard to the immunostaining patterns of these antibodies, there was no significant difference to enable delineation between partial and complete moles, or between a hydropic abortus and a partial mole. Monoclonal anti-cytokeratin was most sensitive for trophoblasts, but less specific for intermediate trophoblasts than HPL. Although an immunohistochemical study using antibodies against beta HCG, HPL, PLAP and PKK1 is very useful for characterizing various trophoblasts, it is considered that an immunohistochemical study may not be a suitable tool for the differential diagnosis of molar and non-molar hydropic placentas.
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PMID:Immunohistochemistry of molar and non-molar placentas with special reference to their differential diagnosis. 750 73

One-hundred-and-four cases of histopathologically confirmed hydatiform moles were subjected to ultrasound examination at the Hung Vuong Hospital, Ho-Chi-Minh-ville (Vietnam) over a period of 16 months (1988-1989). The diagnosis was confirmed only in some cases on clinical grounds (18%) or by laboratory tests (52%). In contrast, typical ultrasound signs were found in 82% of cases; in the other 18% of cases, other aspects had suggested disorders calling for aspiration (partial mole, clear ovum, pregnancy terminated). Some ultrasound images, highly suggestive of mole, were found in occasional cases of mucoid ovarian cyst, endometrial cancer or cystic necrobiosis of fibroma (HCG tests negative). Despite its limitations in Vietnam ultrasound constitutes the primary method of detecting hydatiform mole, the acquisition of practical experience is facilitated by the high number of cases and the concentration of cases reported.
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PMID:[Hydatidiform mole in Vietnam. The contribution of ultrasonography]. 789 73

Coexistence of a complete mole and a normal fetus is a rare event. First trimester sonographic appearance of a complete molar pregnancy with a coexistent fetus and its sonographic differentiation from entities that may simulate a hydatidiform mole in its early stages is discussed. The reported case is one of a 19 y/o woman G2P1001 who was hospitalized several times for abnormal uterine bleeding. Characteristically, the sonographic appearance of a hydatidiform mole is of a moderately echogenic, multicystic intrauterine soft tissue mass. In this particular case, the initial presentation was that of a complex intrauterine fundal mass adjacent to a normal embryo, thus molar pregnancy was considered as part of the differential diagnosis. Doppler evaluation of the echogenic intrauterine mass has been proposed in addition to HCG evaluation, in order to differentiate from trophoblastic and non-trophoblastic disease. In differentiating between a partial and a complete molar pregnancy it is most important to realize that the diagnosis is difficult by ultrasonography because both present with the same multicystic or vesicular pattern. However, if there is a coexistent fetus such as in our reported case, the differentiation would be possible on basis of the presence of a sonographically normal placenta separated from the degenerated placenta.
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PMID:Sonographic diagnosis of complete mole and co-existent fetus: case report. 891 38

The authors report a retrospective study of 105 observations of gestational trophoblastic diseases managed at the university clinic of obstetric gynecology I (Pr Chaoui). Of this study, one listed 72 cases of complete mole hydatiforme with 5 cases of sacrofetal pregnancy. The invasive mole is found in 4 cases and the choriocarcinoma in 24 cases. The general frequency of this pathology is of 1/770 pregnancies. The age of our patients varies from 15 to 52 years with an average age 27 years and the multiparity is found in 50% of the cases. 103 patients (95.5%) consulted for metrorrhagia associated pelvic pains in 31 cases (30%). The toxic syndrome was present in 20 patients (12%) with a preeclampsy in 6 cases (5.71%). The physical examination showed a very increased uterus of size in 92 cases (87.5%) associated adnexal mass in 37 cases (35.2%). The diagnosis was especially echographic in the totality of the cases associated or not with a proportioning of plasmatic beta HCG or prolans urinary. The treatment of the trophoblastic disease varies simple endo-uterine aspiration (85%) until the chemotherapy treatment (32.4%), the hysterectomy was indicated in a third of the cases. The evolution of the non complicated mole hydatiforme was good in 100% of the cases, it quasi totality of the invasive moles presented a complete remission. Among the 24 choriocarcinoma, we deplore 4 deaths in a table of pulmonary, hepatic and cerebral metastases. In order to improve the forecast of these diseases, the diagnosis must be early with an adequate treatment and a rigorous monitoring.
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PMID:[Gestational trophoblastic diseases. Apropos of 105 cases]. 1187 64

Choriocarcinoma are malignant neoplastic tumors from the trophoblastic tissue with a tendency to early metastases. Beside pulmonary metastases there are often cerebral metastases, leading to intracerebral hemorrhage often responsible for the first clinical symptoms. In young women, symptoms like vaginal or pulmonary bleeding or neurologic disturbances shortly after a hydatiform mole or a normal pregnancy, accompanied by high levels of HCG in serum and CSF, choriocarcinoma should be considered. Choriocarcinoma are very sensitive to chemotherapy, which consists--depending on the stage of the disease--of a mono- or polychemotherapy. Cure rates are high, even in extended stages with cerebral metastases--as in the case described. Brain metastases with or without oncotic aneurysms can be rapidly controlled by immediate whole brain irradiation. Surgical interventions may be necessary in the case of life threatening bleedings. Levels of HCG in serum and cerebrospinal fluid are good markers to control the effect of therapy. But--as shown in this patient--levels of HCG in CSF may decrease protracted without affecting prognosis. Oncotic aneurysms are rarely reported and mostly detected post mortem. The presented case leads to a more optimistic attitude and demonstrates efficacy of immediately started radio- and chemotherapy.
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PMID:[Cerebral metastasis in choriocarcinoma a case report]. 1274 Nov

A case of partial hydatidiform mole is presented, occurring in a young primiparous woman after natural conception. She presented with incomplete miscarriage. Histological diagnosis of partial mole was made. Failure of beta HCG to fall resulted in the start of chemotherapy. WHO scoring placed her in low risk group. In spite of the low risk, she required third line chemotherapy for complete eradication of disease.
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PMID:Partial hydatidiform mole. 1567 May 29


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