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Partial Hydatidiform Mole

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Gestational Trophoblastic Disease

Part of the book series: Current Clinical Pathology ((CCPATH))

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Abstract

Hydatidiform moles are nonneoplastic proliferations of the villous trophoblasts, with two distinct subtypes: complete and partial hydatidiform moles (PHMs). While they share some basic features, that is, hydropic placenta/chorionic villi and trophoblastic hyperplasia, partial and complete moles have significant differences in their genetic composition, clinical presentation, histomorphology, and the subsequent risk of developing persistent gestational trophoblastic disease (GTD) and gestational trophoblastic neoplasia (GTN). At the genetic level, PHMs are typically diandric monogynic triploid gestations, most often arising from two sperms fertilizing an egg. Complete moles on the other hand are most commonly diploid or tetraploid and are entirely paternally derived.

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References

  1. Carr DH. Cytogenetics and the pathology of hydatidiform degeneration. Obstet Gynecol. 1969;33(3):333–42.

    PubMed  CAS  Google Scholar 

  2. Makino S, Sasaki MS, Fukuschima T. Triploid chromosome constitution in human chorionic lesions. Lancet. 1964;2(7372):1273–5.

    Article  PubMed  CAS  Google Scholar 

  3. Szulman AE, Surti U. The syndromes of hydatidiform mole. I. Cytogenetic and morphologic correlations. Am J Obstet Gynecol. 1978;131(6):665–71.

    PubMed  CAS  Google Scholar 

  4. Szulman AE, Surti U. The syndromes of hydatidiform mole. II. Morphologic evolution of the complete and partial mole. Am J Obstet Gynecol. 1978;132(1):20–7.

    PubMed  CAS  Google Scholar 

  5. Honore LH, Dill FJ, Poland BJ. The association of hydatidiform mole and trisomy 2. Obstet Gynecol. 1974;43(2):232–7.

    PubMed  CAS  Google Scholar 

  6. Vassilakos P, Kajii T. Letter: hydatidiform mole: two entities. Lancet. 1976;1(7953):259.

    Article  PubMed  CAS  Google Scholar 

  7. Vassilakos P, Riotton G, Kajii T. Hydatidiform mole: two entities. A morphologic and cytogenetic study with some clinical consideration. Am J Obstet Gynecol. 1977;127(2):167–70.

    PubMed  CAS  Google Scholar 

  8. Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J Obstet Gynecol. 2010;203(6):531–9.

    Article  PubMed  Google Scholar 

  9. Smith HO. Gestational trophoblastic disease epidemiology and trends. Clin Obstet Gynecol. 2003;46(3):541–56.

    Article  PubMed  Google Scholar 

  10. Atrash HK, Hogue CJ, Grimes DA. Epidemiology of hydatidiform mole during early gestation. Am J Obstet Gynecol. 1986;154(4):906–9.

    PubMed  CAS  Google Scholar 

  11. Hancock BW, Seckl MJ, Berkowitz RS. Gestational trophoblastic disease. London; 2009, Chapter 3, pp. 49–96.

    Google Scholar 

  12. Smith HO, Hilgers RD, Bedrick EJ, Qualls CR, Wiggins CL, Rayburn WF, et al. Ethnic differences at risk for gestational trophoblastic disease in New Mexico: a 25-year population-based study. Am J Obstet Gynecol. 2003;188(2):357–66.

    Article  PubMed  Google Scholar 

  13. Berkowitz RS, Cramer DW, Bernstein MR, Cassells S, Driscoll SG, Goldstein DP. Risk factors for complete molar pregnancy from a case-control study. Am J Obstet Gynecol. 1985;152(8):1016–20.

    PubMed  CAS  Google Scholar 

  14. Berkowitz RS, Bernstein MR, Harlow BL, Rice LW, Lage JM, Goldstein DP, et al. Case-control study of risk factors for partial molar pregnancy. Am J Obstet Gynecol. 1995;173(3 Pt 1):788–94.

    Article  PubMed  CAS  Google Scholar 

  15. Szulman AE, Surti U. The clinicopathologic profile of the partial hydatidiform mole. Obstet Gynecol. 1982;59(5):597–602.

    PubMed  CAS  Google Scholar 

  16. Altman AD, Bentley B, Murray S, Bentley JR. Maternal age-related rates of gestational trophoblastic disease. Obstet Gynecol. 2008;112(2 Pt 1):244–50.

    Article  PubMed  Google Scholar 

  17. Tham BW, Everard JE, Tidy JA, Drew D, Hancock BW. Gestational trophoblastic disease in the Asian population of Northern England and North Wales. BJOG. 2003;110(6):555–9.

    Article  PubMed  CAS  Google Scholar 

  18. Jeffers MD, O’Dwyer P, Curran B, Leader M, Gillan JE. Partial hydatidiform mole: a common but underdiagnosed condition. A 3-year retrospective clinicopathological and DNA flow cytometric analysis. Int J Gynecol Pathol. 1993;12(4):315–23.

    Article  PubMed  CAS  Google Scholar 

  19. Bifulco C, Johnson C, Hao L, Kermalli H, Bell S, Hui P. Genotypic analysis of hydatidiform mole: an accurate and practical method of diagnosis. Am J Surg Pathol. 2008;32(3):445–51.

    Article  PubMed  Google Scholar 

  20. Genest DR, Ruiz RE, Weremowicz S, Berkowitz RS, Goldstein DP, Dorfman DM. Do nontriploid partial hydatidiform moles exist? A histologic and flow cytometric reevaluation of nontriploid specimens. J Reprod Med. 2002;47(5):363–8.

    PubMed  Google Scholar 

  21. Lawler SD, Fisher RA, Pickthall VJ, Povey S, Evans MW. Genetic studies on hydatidiform moles. I. The origin of partial moles. Cancer Genet Cytogenet. 1982;5(4):309–20.

    Article  PubMed  CAS  Google Scholar 

  22. Jacobs PA, Szulman AE, Funkhouser J, Matsuura JS, Wilson CC. Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann Hum Genet. 1982;46(Pt 3):223–31.

    Article  PubMed  CAS  Google Scholar 

  23. Zaragoza MV, Surti U, Redline RW, Millie E, Chakravarti A, Hassold TJ. Parental origin and phenotype of triploidy in spontaneous abortions: predominance of diandry and association with the partial hydatidiform mole. Am J Hum Genet. 2000;66(6):1807–20.

    Article  PubMed  CAS  Google Scholar 

  24. McFadden DE, Robinson WP. Phenotype of triploid embryos. J Med Genet. 2006;43(7):609–12.

    Article  PubMed  CAS  Google Scholar 

  25. Hassold T, Chen N, Funkhouser J, Jooss T, Manuel B, Matsuura J, et al. A cytogenetic study of 1000 spontaneous abortions. Ann Hum Genet. 1980;44(Pt 2):151–78.

    Article  PubMed  CAS  Google Scholar 

  26. Szulman AE, Philippe E, Boue JG, Boue A. Human triploidy: association with partial hydatidiform moles and nonmolar conceptuses. Hum Pathol. 1981;12(11):1016–21.

    Article  PubMed  CAS  Google Scholar 

  27. Genest DR. Partial hydatidiform mole: clinicopathological features, differential diagnosis, ploidy and molecular studies, and gold standards for diagnosis. Int J Gynecol Pathol. 2001;20(4):315–22.

    Article  PubMed  CAS  Google Scholar 

  28. Surti U, Szulman AE, Wagner K, Leppert M, O’Brien SJ. Tetraploid partial hydatidiform moles: two cases with a triple paternal contribution and a 92, XXXY karyotype. Hum Genet. 1986;72(1):15–21.

    Article  PubMed  CAS  Google Scholar 

  29. Sheppard DM, Fisher RA, Lawler SD, Povey S. Tetraploid conceptus with three paternal contributions. Hum Genet. 1982;62(4):371–4.

    Article  PubMed  CAS  Google Scholar 

  30. Paradinas FJ, Fisher RA, Browne P, Newlands ES. Diploid hydatidiform moles with fetal red blood cells in molar villi. 1 – Pathology, incidence, and prognosis. J Pathol. 1997;181(2):183–8.

    Article  PubMed  CAS  Google Scholar 

  31. Fisher RA, Paradinas FJ, Soteriou BA, Foskett M, Newlands ES. Diploid hydatidiform moles with fetal red blood cells in molar villi. 2 – Genetics. J Pathol. 1997;181(2):189–95.

    Article  PubMed  CAS  Google Scholar 

  32. Berkowitz RS, Goldstein DP. Clinical practice. Molar pregnancy. N Engl J Med. 2009;360(16):1639–45.

    Article  PubMed  CAS  Google Scholar 

  33. Czernobilsky B, Barash A, Lancet M. Partial moles: a clinicopathologic study of 25 cases. Obstet Gynecol. 1982;59(1):75–7.

    PubMed  CAS  Google Scholar 

  34. Fine C, Bundy AL, Berkowitz RS, Boswell SB, Berezin AF, Doubilet PM. Sonographic diagnosis of partial hydatidiform mole. Obstet Gynecol. 1989;73(3 Pt 1):414–8.

    PubMed  CAS  Google Scholar 

  35. Naumoff P, Szulman AE, Weinstein B, Mazer J, Surti U. Ultrasonography of partial hydatidiform mole. Radiology. 1981;140(2):467–70.

    PubMed  CAS  Google Scholar 

  36. Sebire NJ, Fisher RA, Rees HC. Histopathological diagnosis of partial and complete hydatidiform mole in the first trimester of pregnancy. Pediatr Dev Pathol. 2003;6(1):69–77.

    Article  PubMed  Google Scholar 

  37. Fowler DJ, Lindsay I, Seckl MJ, Sebire NJ. Histomorphometric features of hydatidiform moles in early pregnancy: relationship to detectability by ultrasound examination. Ultrasound Obstet Gynecol. 2007;29(1):76–80.

    Article  PubMed  CAS  Google Scholar 

  38. Doshi N, Surti U, Szulman AE. Morphologic anomalies in triploid liveborn fetuses. Hum Pathol. 1983;14(8):716–23.

    Article  PubMed  CAS  Google Scholar 

  39. Daniel A, Wu Z, Bennetts B, Slater H, Osborn R, Jackson J, et al. Karyotype, phenotype and parental origin in 19 cases of triploidy. Prenat Diagn. 2001;21(12):1034–48.

    Article  PubMed  CAS  Google Scholar 

  40. McFadden DE, Kalousek DK. Two different phenotypes of fetuses with chromosomal triploidy: correlation with parental origin of the extra haploid set. Am J Med Genet. 1991;38(4):535–8.

    Article  PubMed  CAS  Google Scholar 

  41. Redline RW, Hassold T, Zaragoza MV. Prevalence of the partial molar phenotype in triploidy of maternal and paternal origin. Hum Pathol. 1998;29(5):505–11.

    Article  PubMed  CAS  Google Scholar 

  42. Fukunaga M. Histopathologic study of partial hydatidiform moles and DNA triploid placentas. Pathol Int. 1994;44(7):528–34.

    Article  PubMed  CAS  Google Scholar 

  43. Paradinas FJ, Browne P, Fisher RA, Foskett M, Bagshawe KD, Newlands E. A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non-molar hydropic abortions. Histopathology. 1996;28(2):101–10.

    Article  PubMed  CAS  Google Scholar 

  44. Fukunaga M, Katabuchi H, Nagasaka T, Mikami Y, Minamiguchi S, Lage JM. Interobserver and intraobserver variability in the diagnosis of hydatidiform mole. Am J Surg Pathol. 2005;29(7):942–7.

    Article  PubMed  Google Scholar 

  45. Frierson Jr HF. Flow cytometric analysis of ploidy in solid neoplasms: comparison of fresh tissues with formalin-fixed paraffin-embedded specimens. Hum Pathol. 1988;19(3):290–4.

    Article  PubMed  Google Scholar 

  46. Yver M, Carles D, Bloch B, Bioulac-Sage P, Martin Negrier ML. Determination of DNA ploidy by fluorescence in situ hybridization (FISH) in hydatidiform moles: evaluation of FISH on isolated nuclei. Hum Pathol. 2004;35(6):752–8.

    Article  PubMed  CAS  Google Scholar 

  47. Cheung AN, Ngan HY, Chen WZ, Loke SL, Collins RJ. The significance of proliferating cell nuclear ­antigen in human trophoblastic disease: an immunohistochemical study. Histopathology. 1993;22(6):565–8.

    Article  PubMed  CAS  Google Scholar 

  48. Suresh UR, Hale RJ, Fox H, Buckley CH. Use of proliferation cell nuclear antigen immunoreactivity for distinguishing hydropic abortions from partial hydatidiform moles. J Clin Pathol. 1993;46(1):48–50.

    Article  PubMed  CAS  Google Scholar 

  49. Olvera M, Harris S, Amezcua CA, McCourty A, Rezk S, Koo C, et al. Immunohistochemical expression of cell cycle proteins E2F-1, Cdk-2, Cyclin E, p27(kip1), and Ki-67 in normal placenta and gestational trophoblastic disease. Mod Pathol. 2001;14(10):1036–42.

    Article  PubMed  CAS  Google Scholar 

  50. Fukunaga M. Immunohistochemical characterization of p57(KIP2) expression in early hydatidiform moles. Hum Pathol. 2002;33(12):1188–92.

    Article  PubMed  CAS  Google Scholar 

  51. Castrillon DH, Sun D, Weremowicz S, Fisher RA, Crum CP, Genest DR. Discrimination of complete hydatidiform mole from its mimics by immunohistochemistry of the paternally imprinted gene product p57KIP2. Am J Surg Pathol. 2001;25(10):1225–30.

    Article  PubMed  CAS  Google Scholar 

  52. Lipata F, Parkash V, Talmor M, Bell S, Chen S, Maric V, et al. Precise DNA genotyping diagnosis of hydatidiform mole. Obstet Gynecol. 2010;115(4):784–94.

    Article  PubMed  Google Scholar 

  53. McConnell TG, Murphy KM, Hafez M, Vang R, Ronnett BM. Diagnosis and subclassification of hydatidiform moles using p57 immunohistochemistry and molecular genotyping: validation and prospective analysis in routine and consultation practice settings with development of an algorithmic approach. Am J Surg Pathol. 2009;33(6):805–17.

    Article  PubMed  Google Scholar 

  54. Kovacs BW, Shahbahrami B, Tast DE, Curtin JP. Molecular genetic analysis of complete hydatidiform moles. Cancer Genet Cytogenet. 1991;54(2):143–52.

    Article  PubMed  CAS  Google Scholar 

  55. Bell KA, Van Deerlin V, Addya K, Clevenger CV, Van Deerlin PG, Leonard DG. Molecular genetic testing from paraffin-embedded tissue distinguishes nonmolar hydropic abortion from hydatidiform mole. Mol Diagn. 1999;4(1):11–9.

    Article  PubMed  CAS  Google Scholar 

  56. Hui P. Molecular diagnosis of gestational trophoblastic disease. Expert Rev Mol Diagn. 2010;10(8):1023–34.

    Article  PubMed  CAS  Google Scholar 

  57. van Lijnschoten G, Arends JW, Leffers P, De La Fuente AA, Van Der Looij HJ, Geraedts JP. The value of histomorphological features of chorionic villi in early spontaneous abortion for the prediction of karyotype. Histopathology. 1993;22(6):557–63.

    Article  PubMed  Google Scholar 

  58. van Lijnschoten G, Arends JW, Geraedts JP. Comparison of histological features in early spontaneous and induced trisomic abortions. Placenta. 1994;15(7):765–73.

    Article  PubMed  Google Scholar 

  59. Norris-Kirby A, Hagenkord JM, Kshirsagar MP, Ronnett BM, Murphy KM. Abnormal villous morphology associated with triple trisomy of paternal origin. J Mol Diagn. 2010;12(4):525–9.

    Article  PubMed  CAS  Google Scholar 

  60. Redline RW, Hassold T, Zaragoza M. Determinants of villous trophoblastic hyperplasia in spontaneous abortions. Mod Pathol. 1998;11(8):762–8.

    PubMed  CAS  Google Scholar 

  61. Paradinas FJ, Sebire NJ, Fisher RA, Rees HC, Foskett M, Seckl MJ, et al. Pseudo-partial moles: placental stem vessel hydrops and the association with Beckwith-Wiedemann syndrome and complete moles. Histopathology. 2001;39(5):447–54.

    Article  PubMed  CAS  Google Scholar 

  62. Pham T, Steele J, Stayboldt C, Chan L, Benirschke K. Placental mesenchymal dysplasia is associated with high rates of intrauterine growth restriction and fetal demise: a report of 11 new cases and a review of the literature. Am J Clin Pathol. 2006;126(1):67–78.

    Article  PubMed  Google Scholar 

  63. Horowitz NS, Goldstein DP, Berkowitz RS. Management of gestational trophoblastic neoplasia. Semin Oncol. 2009;36(2):181–9.

    Article  PubMed  CAS  Google Scholar 

  64. Rice LW, Berkowitz RS, Lage JM, Goldstein DP, Bernstein MR. Persistent gestational trophoblastic tumor after partial hydatidiform mole. Gynecol Oncol. 1990;36(3):358–62.

    Article  PubMed  CAS  Google Scholar 

  65. Gaber LW, Redline RW, Mostoufi-Zadeh M, Driscoll SG. Invasive partial mole. Am J Clin Pathol. 1986;85(6):722–4.

    PubMed  CAS  Google Scholar 

  66. Honig A, Rieger L, Kristen P, Eck M, Frambach T, Tschammler A, et al. A case of metastasizing invasive hydatidiform mole. Is less–less good? Review of the literature with regard to adequate treatment. Eur J Gynaecol Oncol. 2005;26(2):158–62.

    PubMed  CAS  Google Scholar 

  67. Seckl MJ, Fisher RA, Salerno G, Rees H, Paradinas FJ, Foskett M, et al. Choriocarcinoma and partial hydatidiform moles. Lancet. 2000;356(9223):36–9.

    Article  PubMed  CAS  Google Scholar 

  68. Feltmate CM, Growdon WB, Wolfberg AJ, Goldstein DP, Genest DR, Chinchilla ME, et al. Clinical characteristics of persistent gestational trophoblastic neoplasia after partial hydatidiform molar pregnancy. J Reprod Med. 2006;51(11):902–6.

    PubMed  Google Scholar 

  69. Curry SL, Hammond CB, Tyrey L, Creasman WT, Parker RT. Hydatidiform mole: diagnosis, management, and long-term followup of 347 patients. Obstet Gynecol. 1975;45(1):1–8.

    PubMed  CAS  Google Scholar 

  70. Berkowitz RS, Goldstein DP. Chorionic tumors. N Engl J Med. 1996;335(23):1740–8.

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Pathology, Yale University School of Medicine, 310 Cedar Street, 208023, New Haven, CT, 06520-8023, USA

    Natalia Buza MD

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Correspondence to Natalia Buza MD .

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  1. , Department of Pathology, Yale University School of Medicine, 310 Cedar St., New Haven, 06520-8023, USA

    Pei Hui

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Buza, N. (2012). Partial Hydatidiform Mole. In: Hui, P. (eds) Gestational Trophoblastic Disease. Current Clinical Pathology. Springer, New York, NY. https://doi.org/10.1007/978-1-61779-394-3_5

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