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Biomedical subjects

U Surti

Publications and source records attributed to U Surti.

83 records · Page 5Linked to original sources

Dispermic origin and clinical outcome of three complete hydatidiform moles with 46,XY karyotype.

Three new cases of complete, classic hydatidiform mole with a 46,XY karyotype are described. They originated by dispermy as demonstrated by chromosome and enzyme analyses. Levels of human chorionic gonadotropin decreased to normal spontaneously within a short time, indicating a benign course in these three cases. Of a total of 18 cases reported to data, postoperative clinical information was available for 10 patients. Two of these 10 patients had a malignant course with lung metastases. It is of theoretical and clinical importance to establish the magnitude of the risk of malignancy for hydatidiform mole with a 46,XY karyotype.

Adult↗

The clinicopathologic profile of the partial hydatidiform mole.

Having delineated the complete and the partial hydatidiform moles as 2 separate entities on the basis or morphology and cytogenetics, the authors studied 201 molar pregnancies at the Magee-Womens Hospital in an attempt to characterize the clinicopathologic profile of the partial mole syndrome. This was done mainly by comparison and contrast with the established and more familiar syndrome of the classic complete mole. The partial mole syndrome displays most of the pathologic and clinical features of the classic mole and seems to represent a milder, dilute version of the latter. This applies to placental morphology, to the fate of the embryo/fetus, and to human chorionic gonadotropin (hCG) levels as well as to the incidence and severity of clinically persistent trophoblastic disease. Preeclampsia can be equally severe in both syndromes, but tends to occur later in patients with partial mole. No metastatic disease was encountered in association with partial moles and no case of overt choriocarcinoma has yet been described. The occurrence of trophoblastic disease (as determined by postoperative hCG titers) following partial moles requires further inquiry, including study of the pathology of the underlying lesion(s), which remain virtually unexplored.

Abortion, Missed↗

Ultrasonography of partial hydatidiform mole.

Partial hydatidiform mole differs from complete mole by its focal distribution, its slower transformation, the presence of an embryo or fetus, and the triploid karyotype. Nineteen pathologically proved cases are presented. Partial mole can be diagnosed by a combination of the following sonographic findings: (a) greatly enlarged placenta relative to the size of the uterine cavity, (b) cystic spaces within the placenta ("molar placenta"), which may not always be present, (c) an amniotic cavity (gestational sac), either empty or containing amorphous fetal echoes, and (d) a well-formed but growth-retarded fetus, either dead or alive.

Abortion, Spontaneous↗

The syndromes of hydatidiform mole. II. Morphologic evolution of the complete and partial mole.

Hydatidiform moles studied with respect to cytogenetics and morphologic constitution were divisible into two syndromes: (1) complete, classical mole giving a 46 XX karyotype and (2) partial mole with an ascertainable embryo/fetus, dead or alive, giving a triploid karyotype. The complete moles undergo early and total hydatidiform change from edema to central cistern formation, the embryos proper having perished before the establishment of a functioning circulation. Trophoblastic hyperplasia is conspicuous and the connection of this group to chorioncarcinoma is well established. In the partial moles there is a slow hydatidiform change that affects only some of the villi, but which seems to follow along the same lines as in complete moles. There is focal moderate trophoblastic hyperplasia, villous "trophoblastic inclusions" (that appear in triploids only), and maze-like central cisterns in the later cases. The partial mole, 46 XX, partakes of morphologic characteristics of both main syndromes and may represent an unusual syndrome of its own. The two main syndromes can now be distinguished morphologically and the question of the association of the partial mole with chorioncarcinoma has now to be further studied.

Female↗

The syndromes of hydatidiform mole. I. Cytogenetic and morphologic correlations.

Cytogenetic and morphologic analysis of 23 hydatidiform moles allowed the division into at least two syndromes: (1) the syndrome of complete (classical) mole is without an ascertainable embryo/fetus, gives a diploid karyotype, and manifests a progressive fluid engorgement of the villi as well as a gross, haphazardly distributed trophoblastic hyperplasia; (2) the syndrome of partial (incomplete) mole has an ascertainable fetus (alive or dead), gives a triploid karyotype, and exhibits a slowly progressing hydatidiform swelling in the presence of functioning villous capillaries that spares many villi; trophoblastic immaturity is constant and focal hyperplasia is inconspicuous but present. A single case of diploid mole with unusual morphologic features, complete with a fetus, may herald yet another syndrome. Human chorionic gonadotropin levels were initially high in practically all cases. There was no malignant trophoblastic disease in this small series, but a plea is made that partial moles be followed carefully in order to establish their relation to choriocarcinoma.

Adolescent↗

Nongestational choriocarcinoma in the postpartum period: a case report.

PURPOSE: To determine the tissue of origin (gestational versus nongestational) of an extensive metastatic choriocarcinoma in an 18-year-old woman to determine prognosis and treatment. METHODS: DNA microsatellite polymorphisms after polymerase chain reaction (PCR) amplification of the tumor tissue and blood from the patient, husband, and daughter were used to determine the tissue of origin. RESULTS: Molecular analyses revealed that the tumor shared the genetic features of only the patient. She responded well to multiagent chemotherapy. CONCLUSIONS: Molecular analysis is a useful tool to determine whether a choriocarcinoma occurring in a female patient of child-bearing age is gestational or nongestational when clinical findings are not clearly indicative of the primary.

Adolescent↗