Images in Clinical Medicine

Hydatidiform Mole

J.F. Graadt van Roggen, M.B., Ch.B., Ph.D., and V.T.H.B.M. Smit, M.D., Ph.D.

N Engl J Med 2001; 345:503August 16, 2001

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Figure 1 A 29-year-old woman with no previous pregnancies presented with a nine-week history of amenorrhea. The serum levels of the beta subunit of chorionic gonadotropin (peak, 117,000 U per liter) and ultrasonographic findings were indicative of a molar pregnancy. Dilation and curettage was performed; 10 weeks later, serum levels of the beta subunit of chorionic gonadotropin were undetectable and the patient was well. Gross analysis of the uterine contents demonstrated enlarged, edematous villi with a classic grape-like appearance (Panel A). No fetal parts were present. Histopathological analysis showed markedly edematous chorionic villi with circumferential, haphazard proliferation of trophoblasts on the villous surface and mild cytologic atypia (Panel B; hematoxylin and eosin, ×50). The latter is not an unusual finding. The findings are compatible with the presence of a complete hydatidiform mole.

J.F. Graadt van Roggen, M.B., Ch.B., Ph.D.
V.T.H.B.M. Smit, M.D., Ph.D.
Leiden University Medical Center, 2300 RC Leiden, the Netherlands

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