Gestational trophoblastic tumours following initial diagnosis of partial hydatidiform mole.

Abstract

11 patients registered with an initial diagnosis of partial hydatidiform mole (PHM) subsequently required chemotherapy for a gestational trophoblastic tumour. In a retrospective review by histopathological examination and measurement of DNA ploidy, the diagnosis was confirmed as PHM in 5 cases and revised to complete hydatidiform mole in 4; in 2 cases there was no evidence of a molar pregnancy. 4 of the patients with PHM had no other known pregnancy before the gestational trophoblastic tumour and in 2 of these patients the tumour was diagnosed histologically as choriocarcinoma. Not all patients in whom PHM was diagnosed at referring hospitals proved to have the condition. Although the risk of a patient with PHM requiring chemotherapy for gestational trophoblastic tumour is of the order of 1 in 200, compared with 1 in 12 after a complete mole, there is no justification for excluding a patient from follow-up after the evacuation of a PHM.