Malignant mole

Malignant mole
[Summary]



Hydatidiform mole-like blisters over organizations of the uterine cavity penetrated deep myometrium or transferred to other sites, known as malignant mole. For the occurrence of 5% ~ 20% of the dioxin become malignant mole mole or choriocarcinoma, the majority of the mole removed after six months, but have not hydatidiform mole from the malignant transformation to occur before. Although malignant mole with malignant characteristics, treatment and prognosis is better than choriocarcinoma.



[Diagnosis]




According to history and clinical manifestations, and auxiliary examination for diagnosis, the specific diagnostic criteria:

1. Urine pregnancy test: hydatidiform mole emptying after more than two months later, no residual confirmed by curettage-fetal block blisters, and urine pregnancy test remained positive, negative or positive and then to have malignant potential.

2.X-ray: malignant mole who often transfer in the lungs, cough, hemoptysis, lung checks must be made, we can see that region of the shadow of cotton cloth in different parts of the lungs, in particular was particularly prevalent in the right lung lower lobe. But no pulmonary lesions, can not be ruled out erosion hydatidiform mole.

3. Diagnostic curettage: If only vaginal bleeding, and other symptoms and signs are not typical, can be used for diagnostic curettage, or if it blew into a small number of decidual necrotic tissue, can not be ruled out invasive hydatidiform mole.


[Treatment]




At present, the use of chemical drug therapy, the specific method of therapy with choriocarcinoma. This does not require the re-birth or over 40 years of age, viable hysterectomy.


[Pathological changes:




Can be seen with the naked eye lesions grape bar, see individual grape bar, but under a villous structures. Its ability to more invasive hydatidiform mole for the strong, often deep myometrial invasion, there are occasional uterine perforation caused perforation of the wall, or even to the surrounding tissue infiltration, or to the lungs, vagina, etc. transfer. Endoscopic to see more proliferation of trophoblastic cells, villous structures can be seen, this is the difference between choriocarcinoma point, obviously bleeding lesions around often.


[Clinical]




1. Vaginal bleeding: hydatidiform mole after emptying still irregular vaginal bleeding, the number of uncertainties, check uterus than normal and slightly soft, genistein cyst persists.

2. Metastases: A blood metastasis to the lungs have hemoptysis; transferred to the vaginal mucosa that have vaginal Purple-blue nodules rupture caused bleeding. Malignant mole individual patients villi erosion perforation myometrium and serosal layer, can cause varying degrees of abdominal bleeding, acute abdominal pain, bleeding can occur shock for a long time.


[Prognosis]




After treatment of malignant mole, the general prognosis is good, but there are still after recurrence and develop into choriocarcinoma possible, it should at least 2 years contraceptive advice, regular follow-up needs.


[Transfer and proliferation --




Hydatidiform mole villi shedding blood circulation after the transfer to other parts of the body, the destruction of organizations, ranging from the size of the hematoma formation, another special feature of malignant mole. To facilitate the use of such features of benign and malignant mole boundaries. As mentioned above, normal pregnancy trophoblast cells can also enter the blood circulation mother, and in other parts of the body found, but we do not have any destructive lesions, benign mole villous epithelium of the course can also be shedding blood supply to the other parts of the body, Like any destructive inflammation embolic the migration and settlement, but can not afford to undermine local role. Therefore, we believe that access to the blood circulation and parts of the villi not to cause destructive benign lesions belong to the contrary shall be vicious. To be clear that the mole villous trophoblast and normal epithelial Although pregnancy can also enter the blood circulation, but in biology and pathology, or the characteristics of different. The same with the two partial break, but the former high probability of malignant transformation. Also malignant mole should distinguish between malignant tumors and treat. Although both transfer and the transfer tissues caused a certain degree of destruction of properties, but the evil Portuguese metastasis is the possibility of their own dissipated, and malignant tumors, and very few self-dissipating.