Hydatidiform Mole: Diagnosis and Treatment

Hydatidiform Mole

• Definition: A type of gestational trophoblastic disease where the placenta grows abnormally and forms a mass of cysts
• Types:
  • Complete mole: Only paternal chromosomes present, no fetal tissue
  • Partial mole: Both paternal and maternal chromosomes present, some fetal tissue
• Symptoms:
  • Vaginal bleeding
  • Abdominal pain
  • Enlarged uterus
• Diagnosis:
  • Ultrasound
  • Serum beta-hCG levels
  • Histopathological examination of uterine tissue
• Treatment:
  • Suction evacuation of the uterus
  • Follow-up with serial beta-hCG levels to monitor for malignant transformation

Choriocarcinoma

• Definition: A malignant type of gestational trophoblastic disease that originates from the placenta
• Characteristics:
  • Highly aggressive and invasive
  • Can metastasize to lungs, brain, and other organs
• Symptoms:
  • Vaginal bleeding
  • Abdominal pain
  • Shortness of breath (if lung metastases)
• Diagnosis:
  • Histopathological examination of uterine tissue
  • Serum beta-hCG levels
  • Imaging studies (e.g. CT, MRI)
• Treatment:
  • Chemotherapy (methotrexate, actinomycin D, etc.)
  • Surgery (in some cases)

Placental Site Trophoblastic Tumor

• Definition: A rare type of gestational trophoblastic disease that originates from the placenta
• Characteristics:
  • Typically develops at the implantation site of the placenta
  • Can be benign or malignant
• Symptoms:
  • Vaginal bleeding
  • Abdominal pain
  • Enlarged uterus
• Diagnosis:
  • Histopathological examination of uterine tissue
  • Serum beta-hCG levels
  • Imaging studies (e.g. CT, MRI)
• Treatment:
  • Hysterectomy (in most cases)
  • Chemotherapy (in some cases)

Epithelioid Trophoblastic Tumor

• Definition: A rare type of gestational trophoblastic disease that originates from the placenta
• Characteristics:
  • Typically develops in the uterus or cervix
  • Can be benign or malignant
• Symptoms:
  • Vaginal bleeding
  • Abdominal pain
  • Enlarged uterus
• Diagnosis:
  • Histopathological examination of uterine tissue
  • Serum beta-hCG levels
  • Imaging studies (e.g. CT, MRI)
• Treatment:
  • Surgery (hysterectomy or tumor resection)
  • Chemotherapy (in some cases)

Molar Pregnancy Complications

• Risk of malignant transformation:
  • Complete mole: 15-20%
  • Partial mole: 0.5-1%
• Other complications:
  • Recurrent molar pregnancy
  • Thyrotoxicosis
  • Preeclampsia
  • Post-molar pregnancy syndrome (rare)
• Follow-up care:
  • Regular beta-hCG level monitoring
  • Imaging studies (e.g. ultrasound, CT)
  • Contraception to prevent pregnancy until beta-hCG levels return to normal

Gestational Trophoblastic Diseases

Hydatidiform Mole

• A type of gestational trophoblastic disease characterized by abnormal placental growth and formation of cysts
• Two types: complete mole (only paternal chromosomes present, no fetal tissue) and partial mole (both paternal and maternal chromosomes present, some fetal tissue)
• Symptoms: vaginal bleeding, abdominal pain, and enlarged uterus
• Diagnosis: ultrasound, serum beta-hCG levels, and histopathological examination of uterine tissue
• Treatment: suction evacuation of the uterus and follow-up with serial beta-hCG levels to monitor for malignant transformation

Choriocarcinoma

• A malignant type of gestational trophoblastic disease originating from the placenta
• Characteristics: highly aggressive and invasive, can metastasize to lungs, brain, and other organs
• Symptoms: vaginal bleeding, abdominal pain, and shortness of breath (if lung metastases)
• Diagnosis: histopathological examination of uterine tissue, serum beta-hCG levels, and imaging studies (e.g. CT, MRI)
• Treatment: chemotherapy (methotrexate, actinomycin D, etc.) and surgery (in some cases)

Placental Site Trophoblastic Tumor

• A rare type of gestational trophoblastic disease originating from the placenta
• Typically develops at the implantation site of the placenta and can be benign or malignant
• Symptoms: vaginal bleeding, abdominal pain, and enlarged uterus
• Diagnosis: histopathological examination of uterine tissue, serum beta-hCG levels, and imaging studies (e.g. CT, MRI)
• Treatment: hysterectomy (in most cases) and chemotherapy (in some cases)

Epithelioid Trophoblastic Tumor

• A rare type of gestational trophoblastic disease originating from the placenta
• Typically develops in the uterus or cervix and can be benign or malignant
• Symptoms: vaginal bleeding, abdominal pain, and enlarged uterus
• Diagnosis: histopathological examination of uterine tissue, serum beta-hCG levels, and imaging studies (e.g. CT, MRI)
• Treatment: surgery (hysterectomy or tumor resection) and chemotherapy (in some cases)

Molar Pregnancy Complications

• Risk of malignant transformation: 15-20% for complete mole and 0.5-1% for partial mole
• Other complications: recurrent molar pregnancy, thyrotoxicosis, preeclampsia, and post-molar pregnancy syndrome (rare)
• Follow-up care: regular beta-hCG level monitoring, imaging studies (e.g. ultrasound, CT), and contraception to prevent pregnancy until beta-hCG levels return to normal