Twin pregnancy with complete hydatidiform mole and co-existing fetus: A report of 15 cases with a clinicopathological analysis and DNA genotyping

Bingjian Lu; Yu Ma; Ying Shao; Enping Xu

doi:10.1016/j.prp.2022.154116

Twin pregnancy with complete hydatidiform mole and co-existing fetus: A report of 15 cases with a clinicopathological analysis and DNA genotyping

Pathol Res Pract. 2022 Oct:238:154116. doi: 10.1016/j.prp.2022.154116. Epub 2022 Sep 6.

Authors

Bingjian Lu¹, Yu Ma², Ying Shao³, Enping Xu⁴

Affiliations

¹ Department of Surgical Pathology and Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: lbj@zju.edu.cn.
² Department of Clinical Laboratory Medicine, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: 5308007@zju.edu.cn.
³ Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: shaoying0559@zju.edu.cn.
⁴ Department of Surgical Pathology, Women's Hospital & Department of Pathology & Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: xep@zju.edu.cn.

PMID: 36095920
DOI: 10.1016/j.prp.2022.154116

Abstract

Complete hydatidiform mole (CHM) with co-existing fetus (CHMCF) is very uncommon. In this study, we investigated the clinicopathological features and DNA genotype in 15 CHMCF. Seven patients (46.7%) developed post-molar gestational trophoblastic disease (GTD), 5 of which had lung metastasis. CHMCF was histologically characterized by a mixed pattern of CHM and the non-molar placenta, mimicking partial hydatidiform mole and placental mesenchymal dysplasia. p57 immunostaining showed a divergent staining pattern, positive in the normal placenta and negative in the CHM component. DNA genotyping of the CHM villi demonstrated exclusively paternal alleles consisting of homozygous/monospermic (n = 9) and heterozygous/dispermic patterns (n = 5) at multiple informative loci. We conclude that CHMCF confers a high risk for post-molar GTD. DNA genotyping contributes significantly to the precision diagnosis of CHMCF.

Keywords: Clinical outcomes; Complete hydatidiform mole; Diagnosis; Genotype; Twin pregnancy.