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At least 19 recordsLinked to original sources
PubMed1978

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↗
PubMed1989

Lectin binding in tissues from hydatidiform mole, invasive mole and choriocarcinoma to concanavalin-A, wheat germ agglutinin and peanut agglutinin.

A light microscopic analysis of lectin receptors in normal placenta and trophoblastic disease was performed utilizing biotinylated Concanavalin-A (Con-A), wheat germ agglutinin (WGA), and peanut agglutinin (PNA), in conjunction with an avidin-biotin peroxidase complex. Hydatidiform mole, invasive mole and choriocarcinoma exhibited increased receptors to Con-A and WGA compared to normal placenta. Increased reactivity to Con-A and WGA was associated merely with increased growth and proliferation of trophoblasts rather than a malignant transformation. Normal placenta, partial and complete mole generally showed moderate to strong binding with PNA after neuraminidase treatment, while invasive mole and choriocarcinoma (11 of 15 cases) generally showed minimal to absent reaction with PNA. Heterogeneity of PNA binding in choriocarcinoma was manifested by the presence of PNA reactivity in the trophoblast membrane in 2 cases wherein no prior neuraminidase treatment was given. This suggests that in some malignant trophoblasts, there is absence of sialic acid in the terminal cell surface carbohydrate groups resulting in the exposure of N-acetylgalactoseamine.

Choriocarcinoma↗
PubMed1988

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles.

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Female↗
PubMedDate not supplied

Epidemiological studies on disturbances of human fetal development in areas with various doses of natural background radiation. II. Relationship between incidences of hydatidiform mole, malignant hydatidiform mole, and chorionepithelioma and gonad dose equivalent rate of natural background radiation.

The relationships between gonad dose equivalent rates and incidences of chorionic disease (i.e., hydatidiform mole, malignant hydatidiform mole, and chorionepithelioma) were analyzed with Kendall's rank correlation and regression methods. Data used were from 11 prefectures of Japan with various dose rates of natural background ionizing radiation between the years 1974 to 1976. The results suggested an association of the incidence of chorionic disease with the radiation dose rate in the very low dose-rate range.

Adult↗
PubMed1988

Immobilized Datura stramonium agglutinin column chromatography, a novel method to discriminate the urinary hCGs of patients with invasive mole and choriocarcinoma from those of normal pregnant women and patients with hydatidiform mole.

Datura stramonium agglutinin (DSA) binds the asparagine-linked sugar chains commonly found in the human chorionic gonadotropin (hCG) purified from urine of patients with invasive mole or choriocarcinoma, but not in that of normal pregnant women or patients with hydatidiform mole. With the use of an immobilized DSA column, a novel method to discriminate urinary hCGs from various trophoblastic diseases was developed.

Carbohydrate Sequence↗
PubMed1992

A flow cytometric study of 137 fresh hydropic placentas: correlation between types of hydatidiform moles and nuclear DNA ploidy.

Hydropic placentas may be classified by histopathology into hydropic abortus, partial hydatidiform mole, and complete hydatidiform mole. We studied 142 hydropic placentas: 39% were complete hydatidiform moles, 35% partial hydatidiform moles, and 26% hydropic abortuses. Villous vesicle size was predictive of histologic diagnosis. We determined DNA ploidy in 137 cases. Seventy-three percent of hydropic abortuses were diploid and 11% were triploid. Ninety percent of partial moles were triploid or near-triploid; one partial mole was haploid and one diploid. Of the complete moles, 50% were diploid, 43% were tetraploid, 3.6% polyploid, and 1.7% triploid. Partial moles had lower pre-evacuation beta-hCG levels than complete moles. Persistent tumor followed 33% of complete moles and 12% of partial moles. Although the numbers were small, no patient with a diploid, tetraploid, aneuploid, or haploid partial mole developed persistent disease. Among complete moles, the pre-evacuation beta-hCG level was not predictive of persistence (P = .15). Subdividing complete moles by ploidy, we found that tetraploid moles were associated with higher pre-evacuation beta-hCG levels than were diploid moles. However, tetraploidy was not associated with increased persistent tumor among complete moles. Although most partial moles were triploid and most complete moles were diploid or tetraploid, there was wider DNA heterogeneity among molar gestations than previously reported. In this series, DNA ploidy was not an independent predictor of persistence in complete moles.

Adolescent↗
PubMed1988

Self-reports of mole counts and cutaneous malignant melanoma in women: methodological issues and risk of disease.

The relation of the presence of moles (nevi) on all four limbs to risk of cutaneous malignant melanoma was explored among 98 incident cases aged 32-59 years at diagnosis and 190 age-matched controls drawn from the Nurses' Health Study, a prospective cohort of female nurses in the United States. Cases diagnosed during follow-up from 1976 to 1982 were included in this study. Participants reported counts of all moles and raised moles alone on postal questionnaires. Distributions of moles were similar for right and left sides on upper and lower limbs for cases and controls. Counts declined with increasing age for all women, from a median of 15 for the youngest tertile of controls (aged 36-46 years) to three for the oldest (aged 54-62 years). Cases had more moles than did controls (medians of 23 and 9, respectively, for total moles on all four limbs): The presence of any mole on a limb gave relative risks for melanoma ranging from 2.2 (95% confidence interval (CI) = 1.2-4.0) for one or more moles on an arm to 2.9 (95% CI = 1.6-5.3) for one or more moles on the lower limb. For raised moles, relative risks were 1.7 (95% CI = 1.0-2.7) for arm, 2.1 (95% CI = 1.3-3.5) for lower limb, and 3.5 (95% CI = 2.0-6.3) for leg (below knee). The highest site-specific risk (i.e., for any moles on the same limb as the melanoma vs. no moles on that limb) was for moles on the lower limb (relative risk = 5.0 (95% CI = 1.8-13.5)). There were positive and significant trends in overall and site-specific risk with increasing numbers of moles on all limbs when absolute mole counts were considered, e.g., for total moles on all four limbs combined, chi for trend = 4.0, one-sided p less than 0.001, with relative risk for more than 100 moles versus none of 6.0. Inclusion of sun exposure and other constitutional factors in logistic regression analyses did not alter these observed relations between the presence of moles and risk of melanoma.

Adult↗
PubMed1991

Risk factors for gestational trophoblastic disease: a separate analysis of complete and partial hydatidiform moles.

Risk factors for complete and partial hydatidiform mole were analyzed in a case-control study conducted in the greater Milan area on 139 complete moles, 49 partial moles, and 410 obstetric control subjects. Patients tended to be more frequently nulliparous than controls, and the risk of complete mole and partial mole decreased with number of births, although the trend in risk was significant only for partial mole (chi 2(1) trend, P = .05). The risk for both histopathologic subgroups was greater in women reporting spontaneous miscarriages. Compared with women with no previous miscarriage, the estimated odds ratios (as estimators of relative risks) were 3.1 and 1.9, respectively, for complete mole and partial mole for two or more miscarriages. Infertility problems or difficulty in conception were associated with an odds ratio of 2.4 (95% confidence interval 1.3-4.3) and 3.2 (95% confidence interval 1.4-7.0), respectively, for complete mole and partial mole. No association emerged between mole and induced abortions and age at first pregnancy. A personal history of gestational trophoblastic disease increased the risk of both complete mole and partial mole: The odds ratios were 12.0 (95% confidence interval 3.0-38.9) and 18.1 (95% confidence interval 5.0-64.7), respectively. Similarly, a family history of gestational trophoblastic disease was more frequently reported in complete mole cases (five of 128) than in controls (one of 395) (odds ratio 16.0, 95% confidence interval 3.2-80.3). When the mating frequencies by patient/husband blood groups were considered, a nonsignificant increased risk was evident for women with group A married to men of group O in both histopathologic subgroups (odds ratio 1.5 compared with all other combinations).(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMedDate not supplied

The propensity to malignancy of dispermic heterozygous moles.

Complete hydatidiform moles may originate from either the fertilization of an empty egg by a haploid sperm followed by duplication (producing a monospermic, homozygous mole) or the fertilization of such an egg by two haploid sperms (producing a dispermic, heterozygous mole). This difference in the mechanism leading to the formation of complete moles raises the question of whether the risk of subsequent malignancy is influenced by the zygosity of the mole. We have compared the incidence of postmolar sequelae in patients with homozygous and heterozygous moles. Using chromosomal heteromorphisms, human lymphocyte antigen (HLA) and phosphoglucuromutase 1 (PGM1) polymorphisms, we established the androgenetic origin of complete mole in 84 of 91 cases. Homozygosity was confirmed in 51 moles, and we found ten heterozygous moles. Five of ten patients with heterozygous moles developed postmolar trophoblastic disease, whereas only two of the 51 patients with homozygous moles had postmolar trophoblastic disease (an additional five patients showed signs of degenerating residual trophoblasts). The XY sex chromosome constitution of the two in vitro choriocarcinoma cell lines examined here provides further evidence of the propensity to malignancy of heterozygous moles.

Choriocarcinoma↗
PubMed1989

Repetitive complete and partial hydatidiform mole.

Fifteen patients with repetitive hydatidiform mole were followed at the New England Trophoblastic Disease Center between 1965-1988. The medical records were examined to determine the patients' age, gravidity, parity, clinical presentation, development of post-molar tumor, and subsequent pregnancy experience. Each molar tissue was reviewed pathologically. Seven patients had repetitive complete hydatidiform mole and three developed persistent post-molar disease after their later mole. Five patients had an initial complete hydatidiform mole followed by a partial hydatidiform mole; two developed persistent post-molar disease after the partial mole. One patient had an initial partial hydatidiform mole followed by a complete hydatidiform mole and required chemotherapy after her complete mole. Two patients had repetitive partial hydatidiform mole, and neither developed post-molar disease. Four of the patients with repetitive mole later achieved a normal viable pregnancy. Molar pregnancies must be categorized as either complete or partial to provide meaningful data concerning repetitive hydatidiform mole.

Adolescent↗
PubMed1987

[The propensity to malignancy of dispermic, heterozygous moles].

Complete hydatidiform moles may originate from either the fertilization of an empty egg by a haploid sperm followed by duplication (producing a monospermic, homozygous mole) or the fertilization of such an egg by 2 haploid sperm (producing a dispermic, heterozygous mole). This difference in the mechanism leading to the formation of complete moles raises the question of whether the risk of subsequent malignancy is influenced by the zygosity of the mole. In the research reported here, we compared the incidence of postmolar sequelae between patients with homozygous and heterozygous moles. Using chromosomal heteromorphism, HLA and PGM1 polymorphisms, we established the androgenetic origin of complete mole in 82 of 91 cases. Homozygosity was confirmed in 51 moles, and we found 10 heterozygous moles. Five of 10 patients with heterozygous moles developed postmolar trophoblastic disease, whereas only 2 of the 51 patients with homozygous moles had postmolar trophoblastic disease (an additional 5 patients showed signs of degenerating residual trophoblasts). A high incidence of sequelae after the expulsion of heterozygous moles suggests that the heterozygous constitution of allelic genes plays an important role in the process of malignant transformation of trophoblasts.

Female↗
PubMed1992

Benign pigmented nevi in children. Prevalence and associated factors: the West Midlands, United Kingdom Mole Study.

BACKGROUND AND METHODS: Prevalence of benign melanocytic nevi (moles) has been shown to be a major predictor of malignant melanoma. In this study the prevalence of moles in a group of 2140 children, aged 4 to 11 years, was determined. A standard questionnaire was completed by the parents of each child and included information on environmental and life-style factors. Examination data for each child were linked to the data obtained from the questionnaire. RESULTS: Prevalence increases rapidly throughout childhood and studies of children may indicate which factors contribute to mole development. Boys had more moles than girls, as did white children when compared with other ethnic groups. Prevalence of moles increased with age in children of both sexes. Among whites, skin color had little influence on mole prevalence. The following characteristics, however, were associated with an increased prevalence of moles: a propensity to burn rather than tan, a history of sunburn, a tendency to freckle, and a life-style involving increased sun exposure. A striking positive association between prevalence of moles and number of foreign holidays in a hot climate was observed. This association was independent of a history of sunburn. CONCLUSIONS: The study supports the hypothesis that environmental factors influence the prevalence of moles in childhood.

Child↗
PubMed1991

A prospective genetic study of complete and partial hydatidiform moles.

Two hundred two hydatidiform moles were classified by pathologic features and ploidy into partial or complete moles. Further classification was made by using genetic polymorphism, the diagnosis being refined by deoxyribonucleic acid technology. Among 51 partial hydatidiform moles, 44 triploids, two tetraploids, and one diploid were identified. Informative triploid partial hydatidiform moles had one maternal and two paternal sets of chromosomes, the likely origin being dispermy. Among 149 complete hydatidiform moles, one was haploid, one was triploid, and 105 were shown to be diploid or androgenetic; 39 of these were proved homozygous, indicating duplication of the male genome, whereas heterozygous origin by dispermy was likely in 13. The locus-specific minisatellite deoxyribonucleic acid probes were particularly useful for the identification of heterozygous complete hydatidiform moles. None of the patients with partial hydatidiform moles had development of a gestational trophoblastic tumor. No difference was detected in the frequency of requirement for chemotherapy between patients with homozygous or heterozygous complete hydatidiform moles.

Blotting, Southern↗
PubMed1991

Flow cytometric analysis of DNA content in partial hydatidiform moles with persistent gestational trophoblastic tumor.

Hydatidiform moles may be classified as partial or complete based on genetic and pathologic criteria. Between January 1979 and January 1990, 17 (5.5%) of 310 patients followed for partial mole developed persistent gestational trophoblastic tumor. Tissues from 14 partial moles were available for flow cytometric analysis of DNA content. Eleven partial moles (85%) were triploid, two (15%) were diploid, and one DNA histogram was uninterpretable. All patients with triploid partial moles achieved complete remission with one course of single-agent chemotherapy. The two with diploid partial mole required multiple courses of chemotherapy to achieve gonadotropin remission. Although the DNA content of most partial moles with persistent gestational trophoblastic tumor was triploid, diploid partial moles with persistent tumor were less sensitive to single-agent chemotherapy.

DNA, Neoplasm↗
PubMed1986

Cytogenetic and clinicopathologic studies of partial moles.

Fifty-six partial moles from 55 patients were karyotyped and analyzed clinicopathologically. Forty-seven were triploid and nine diploid. Triploid partial moles were characterized histologically by focal mild-to-moderate trophoblastic hyperplasia with stromal trophoblastic inclusion. Diploid partial moles lacked marked trophoblastic hyperplasia and stromal trophoblastic inclusions. Four of the nine diploid moles were analyzed for chromosome heteromorphisms, enzyme polymorphisms, and histocompatibility leukocyte antigen specificities to determine their origin, and two were found to be normal. In the follow-up study, none of the partial moles developed into invasive mole or choriocarcinoma. These results indicate that most partial moles are triploid but a minority are normal diploid; regardless of the karyotype, however, partial moles do not have a high propensity for malignancy.

Chorionic Villi↗
PubMed1989

Human chorionic gonadotropin and free subunits' serum levels in patients with partial and complete hydatidiform moles.

Serum levels of hCG and its free subunits were measured in patients with partial and complete hydatidiform moles and in women with normal 10-week pregnancies. whereas complete moles had higher levels of percent-free beta-hCG than partial moles (2.4 versus 1.0; P less than or equal to .005), partial moles had higher levels of percent-free alpha-hCG than complete moles (0.85 versus 0.17; P less than or equal to .005). Normal 10-week pregnancies had lower levels of both percent-free beta-hCG and percent-free alpha-hCG than partial moles (0.40 versus 1.0, P less than or equal to .005 and 0.27 versus 0.85, P less than or equal to .005, respectively). Percent-free beta-hCG and beta-hCG levels did not distinguish which patients with complete mole were more likely to develop persistent post-molar tumor. The trophoblastic cells in complete and partial moles differ significantly in the manner in which they secrete the free subunits of hCG.

Chorionic Gonadotropin↗