Cases reported "Hydatidiform Mole"

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1/7. Partial molar transformation of the placenta of presumably monozygotic twins.

    A pregnancy with one normal female fetus and a placenta that was divided into halves, one normal the other molar, is described. Genetic analysis shows the molar component to be hyperdiploid/tetraploid but having an identical dna composition as the normal twin. Because there was no trophoblastic proliferation and the hyperdiploid cells were confined to the villous stroma, and because the molar component was still being perfused by diploid vessels from the normal twin, we believe the mole is derived from polyploidization of the mesenchymal epiblast in a monozygotic twin pregnancy.
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2/7. Forceps delivery after molar malignancy in a woman with arteriovenous malformation. A case report.

    BACKGROUND: An arteriovenous (AV) fistula in the female pelvis is a rare finding. This report describes a successful pregnancy after selective embolization of a postmolar vascular malformation. CASE: At 5 weeks of pregnancy, a 27-year-old, white female, gravida 3, para 0, was discovered on ultrasound examination to have an AV malformation along with a fetal pole. The patient was asymptomatic and had previously received two courses of chemotherapy for a previous nonmetastasized malignant molar pregnancy. Doppler ultrasonography uncovered a vascular malformation extending from the margin of the fetal pole to the margin of the uterus. The pregnancy ended at 8 weeks with a spontaneous abortion. The patient underwent angiography and embolization of extensive right-sided uterine vessels. She resumed normal menstrual periods six weeks after the embolization and became pregnant. The pregnancy concluded in low forceps vaginal delivery of a healthy, female infant at 34 weeks. CONCLUSION: Vaginal delivery following postmolar pregnancy and a uterine AV malformation may be considered a viable delivery option.
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3/7. Placental mesenchymal dysplasia initially diagnosed as partial mole.

    Placental mesenchymal dysplasia is a rare condition of pregnancy that presents as macroscopic features of molar change in the placenta and normal karyotype fetus. These cases are often misdiagnosed as partial mole. We report a new case of mesenchymal dysplasia. A 27-year-old Japanese primigravida delivered an 820 g female baby (46XX karyotype) without congenital anomalies at 27 weeks gestation due to massive bleeding with placenta previa. The placenta had mimicking partial moles, grape-like vesicles and normal villi that diffusely occupied the area on the maternal surface of the placenta. Pathologically, enlarged stem villi contained loose, moderately cellular connective tissue with focal cistern-like formation, and peripherally located vessels. Abnormal trophoblastic proliferation and trophoblastic inclusions were not observed in any of the sections examined. Some villi contained chorioangiomatoid changes. The mother and child were followed up for more than 5 years and showed no sign of trophoblastic disease or beckwith-wiedemann syndrome features.
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4/7. Complete hydatidiform mole with coexistent live fetus in dichorionic twin gestation.

    CASE REPORT: A 28-year-old patient gravida 3, para 2 was admitted at 16 weeks' gestation with the diagnosis of complete hydatidiform mole with coexistent live fetus (CHMCF) in dichorionic twin gestation. The betaHCG level was 530,000 mIU/ml. The pregnancy was terminated by hysterotomy. OUTCOME: Histopathologic analysis revealed a hydatidiform mole and a 17-week-old male fetus attached to the normal looking placenta by a double-vesseled cord. A final karyotype on cord blood samples confirmed normal 46 XY. Weekly performed serial betaHCG values showed declining trend and were undetectable by 10 weeks post delivery.
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5/7. Uterine cirsoid aneurysm.

    Cirsoid (or varicose) aneurysm of the uterine vessels causes severe, life-threatening uterine bleeding. Previous trophoblastic neoplasia is a common predisposing factor. diagnosis is by arteriography and may be missed without it.
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6/7. Placental vascular malformation with mesenchymal hyperplasia and a localized chorioangioma. A rarity simulating partial mole.

    We here report a case of placental vascular malformation with mesenchymal hyperplasia of the villi and a localized chorioangioma. After an uneventful pregnancy our patient delivered a non-malformed live female infant. The placenta was grossly enlarged, and macroscopically it was characterized by strongly enlarged varicous chorionic vessels. On the maternal plate vesicle-like structures, giving the impression of partial mole, were seen. At microscopy level, areas of normal looking tissue alternated with areas of excessively enlarged villi, in which the ground substance contained large amounts of acid mucopolysaccharide, corresponding to "mesenchymal hyperplasia". Moreover, a localized chorioangioma was found. In none of the histological sections were cisterns, abnormal trophoblastic proliferation, stunted ramification or stromal trophoblastic inclusions observed. In week 15 maternal se-AFP was elevated to 3.03 multiples of the median. Genetic analyses revealed a normal female karyotype and biparental genomic contributions to 7 unlinked loci. Placental vascular malformation with mesenchymal hyperplasia is a differential diagnosis to partial mole which should be considered when vesicle like placental enlargement is observed along with a living fetus.
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7/7. A case of nonmetastatic trophoblastic disease followed by magnetic resonance imaging.

    The consecutive findings of the magnetic resonance (MR) imaging in a patient with nonmetastatic trophoblastic disease are reported. On MR image, there are noted two kinds of MR findings which suggest the existence of trophoblastic disease; one was a typical hypervascular mass of heterogeneous signal intensity within myometrium, and the other was the increase in myometrial and parametrial flow void. The former finding appeared only for a short period while the disease was highly active. The latter finding well paralleled the serum human chorionic gonadotropin (hCG) level, and the remarkable flow void, indicating dilatated blood vessels, disappeared with the complete remission of the disease. These findings suggest that MR imaging may be useful for diagnosing and following gestational trophoblastic disease.
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