Over‐diagnosis of hydatidiform mole in early tubal ectopic pregnancy
- 15 May 2001
- journal article
- research article
- Published by Wiley in Histopathology
- Vol. 38 (5), 409-417
- https://doi.org/10.1046/j.1365-2559.2001.01151.x
Abstract
Over‐diagnosis of hydatidiform mole in early tubal ectopic pregnancy Aims: Tubal ectopic hydatidiform moles are rare lesions, and only 40 cases have been reported in the world literature. We investigated the apparently high incidence of tubal ectopic hydatidiform moles in women referred for treatment to a Supraregional Trophoblastic Tumour Screening and Treatment Centre between 1986 and 1996. Methods and results: Of 4261 women referred during the study period, 25 (0.6%) had a suspected tubal ectopic hydatidiform mole and paraffin‐embedded tissue was available in 20 (80%) of these. Each case was reviewed by two pathologists and DNA flow cytometric analysis was undertaken when the histological diagnosis was initially deemed equivocal or suggestive of hydatidiform mole. On review, 17 cases (85%) showed no evidence of hydatidiform mole (circumferential trophoblastic proliferation, hydrops, scalloped villi, and stromal karyorrhexis). Of these, 11 cases (65%) showed features of early placentation and six (35%) showed hydropic abortion. DNA flow cytometry was performed in 14 (82%) of these cases and revealed a diploid population in each case. Three cases of molar pregnancy (15%) were identified. Each of these cases had the histological features of an early complete hydatidiform mole. Sufficient tissue was available for DNA flow cytometric analysis in two of these cases and confirmed the presence of diploidy in each. Conclusions: Our results show that tubal ectopic hydatidiform mole is a rare entity and demonstrate that it is over‐diagnosed. Polar trophoblastic proliferation and hydropic villi are features of early placentation and of hydropic abortion. Sheets of extravillous trophoblast may be particularly prominent in tubal ectopic gestation. In the absence of circumferential trophoblastic proliferation combined with hydropic change a diagnosis of gestational trophoblastic disease should be avoided.Keywords
This publication has 18 references indexed in Scilit:
- Gestational trophoblastic diseases and their treatmentCancer Treatment Reviews, 1997
- A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non‐molar hydropic abortionsHistopathology, 1996
- Can histopathologists reliably diagnose molar pregnancy?Journal of Clinical Pathology, 1993
- DNA cytometric and interphase cytogenetic analyses of paraffin‐embedded hydatidiform moles and hydropic abortionsThe Journal of Pathology, 1993
- Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform moleThe Lancet, 1990
- Flow cytometry used to distinguish between complete and partial hydatidiform molesPlacenta, 1987
- Diagnosis of molar pregnancy and persistent trophoblastic disease by flow cytometry.Journal of Clinical Pathology, 1987
- HYDATIDIFORM MOLE IN ENGLAND AND WALES 1973-83The Lancet, 1986
- The medical value of examining tissue from therapeutic abortions: an analysis of 13 477 casesBJOG: An International Journal of Obstetrics and Gynaecology, 1986
- Mechanism of origin of complete hydatidiform molesNature, 1980