Partial Molar Pregnancy Presenting as a Tubal Ectopic Pregnancy

Abstract

Background: Tubal molar pregnancy is extremely rare, with no more than 200 cases reported in the literature. The incidence is approximated at 1.5 per 1,000,000 pregnancies.

Case: We report the case of a 22-year-old woman with an overall initial stable clinical presentation who was noted to have a ruptured ectopic pregnancy. She was surgically treated, and pathology revealed partial hydatidiform molar ectopic pregnancy. At the time of surgical intervention, the treating physicians had not considered molar ectopic pregnancy within the differential diagnosis, since this is a very rare presentation. Once the pathology was discovered, the patient was contacted to be scheduled for close follow-up and counseling to reduce progression to choriocarcinomas.

Conclusion: This case report highlights the importance of sending, reviewing, and following up on pathologic specimens for all patients undergoing surgical intervention for presumed ectopic pregnancy and ensuring that appropriate follow-up is in place for those patients.

Figure 1

Transvaginal ultrasound of right adnexa. RT: right; TRANS: transverse.

Figure 2

(a) Low power image of a partial mole shows an admixture of normal-appearing and enlarged hydropic villi scalloped borders. (b) High power image shows nucleated red blood cells (arrow) ((a) original magnification ×100; (b) original magnification ×400, hematoxylin and eosin (H&E) stain).

Figure 3

Genetic profiles of a dispermic partial hydatidiform mole by multiplex PCR assay. Dispermic paternal alleles (with homozygous paternal alleles in duplicate quantity in D8S1179 locus) shown, in addition to the presence of one maternal allele. Normal biallelic profiles seen in the (b) maternal endometrium.