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Case Reports
. 2021 Jun 17:31:e00336.
doi: 10.1016/j.crwh.2021.e00336. eCollection 2021 Jul.

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

Yusuke Taira  1 , Yuko Shimoji  1 , Tadaharu Nakasone  1 , Yoshihisa Arakaki  1 , Tomoko Nakamoto  1 , Tadatsugu Kinjo  1 , Wataru Kudaka  1 , Keiko Mekaru  1 , Yoichi Aoki  1
Affiliations
Case Reports

A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report

Yusuke Taira et al. Case Rep Womens Health. .

Abstract

A complete hydatidiform mole coexisting with a fetus (CHMCF) is a rare form of twin pregnancy. High-risk gestational trophoblastic neoplasia (GTN) can occur after a CHMCF pregnancy, although the frequency is low. In cases of GTN, the clinical diagnosis and that based on the International Federation of Gynecology and Obstetrics (FIGO) scoring system can differ. This case report concerns a patient with a choriocarcinoma that was initially diagnosed and treated as a low-risk stage III GTN following a live birth from a CHMCF pregnancy. We used short tandem repeat (STR) analysis to identify the causative pregnancy as the patient's earlier complete hydatidiform mole. Clinicians should anticipate a high-risk GTN when treating persistent trophoblastic disease (PTD) in patients with a non-typical course.

Keywords: Choriocarcinoma; Complete hydatidiform mole coexisting fetus; Gestational trophoblastic neoplasia; Persistent trophoblastic disease; Short tandem repeat.

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Figures

Fig. 1
Fig. 1
A gross image of the placenta and complete hydatidiform mole delivered after the birth. Normal placenta (➤) and edematous swollen chorionic villi (▷).
Fig. 2
Fig. 2
Microscopic findings of the placenta and complete hydatidiform mole. (A) Normal placenta equivalent to the 37th week of gestation (×100); (B) (C) complete hydatidiform mole (×10, ×100)
Fig. 3
Fig. 3
Histopathological findings of metastatic choriocarcinoma. (A) Hemorrhage and necrosis can be seen inside the mass (×3). (B) Atypical syncytiotrophoblasts, cytotrophoblasts, and intermediate syncytiotrophoblasts proliferated in sheets with hemorrhage and necrosis (×100).
See this image and copyright information in PMC

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