Abstract：
BACKGROUND: Placental mesenchymal dysplasia (PMD) is a benign lesion that is often misdiagnosed as complete (CHM) or partial hydatidiform mole. PMD usually results in live birth but can be associated with several fetal defects. Herein, we report PMD with CHM in a singleton placenta with live birth.
METHODS: A 34-year-old gravida 2, para 1, living 1 (G2P1L1) woman was referred on suspicion of a molar pregnancy in the first trimester. Maternal serum human chorionic gonadotrophin levels were increased during early pregnancy, with multicystic lesions and placentomegaly observed on ultrasonography. Levels decreased to normal with no fetal structural abnormalities observed. A healthy male infant was delivered at 34 gestational weeks. Placental p57KIP2 immunostaining and short tandem repeat analysis revealed three distinct histologies and genetic features: normal infant and placenta, PMD, and CHM. Gestational trophoblastic neoplasia was diagnosed and up to fourth-line chemotherapy administered.
CONCLUSIONS: Distinguishing PMD from hydatidiform moles is critical for avoiding unnecessary termination of pregnancy. CHM coexisting with a live fetus rarely occurs. This case is unique in that a healthy male infant was born from a singleton placenta with PMD and CHM.
METHODS: A 34-year-old gravida 2, para 1, living 1 (G2P1L1) woman was referred on suspicion of a molar pregnancy in the first trimester. Maternal serum human chorionic gonadotrophin levels were increased during early pregnancy, with multicystic lesions and placentomegaly observed on ultrasonography. Levels decreased to normal with no fetal structural abnormalities observed. A healthy male infant was delivered at 34 gestational weeks. Placental p57KIP2 immunostaining and short tandem repeat analysis revealed three distinct histologies and genetic features: normal infant and placenta, PMD, and CHM. Gestational trophoblastic neoplasia was diagnosed and up to fourth-line chemotherapy administered.
CONCLUSIONS: Distinguishing PMD from hydatidiform moles is critical for avoiding unnecessary termination of pregnancy. CHM coexisting with a live fetus rarely occurs. This case is unique in that a healthy male infant was born from a singleton placenta with PMD and CHM.
摘要：
背景：胎盘间质发育不良（PMD）是一种良性病变，常被误诊为完全性（CHM）或部分葡萄胎。PMD通常导致活产，但可能与几个胎儿缺陷有关。在这里，我们报告了在有活产的单胎胎盘中CHM的PMD。
方法：一名34岁的gravida2,para1,living1(G2P1L1)妇女在孕早期因怀疑磨牙妊娠而转诊。MSHCG水平在妊娠早期增加，超声观察多囊性病变和胎盘肿大。水平降至正常，未观察到胎儿结构异常。一名健康的男婴在34孕周分娩。胎盘p57KIP2免疫染色和短串联重复分析揭示了三种不同的组织学和遗传特征：正常婴儿和胎盘，PMD,CHM。诊断为妊娠滋养细胞肿瘤，并进行了四线化疗。
结论：区分PMD和葡萄胎对于避免不必要的终止妊娠至关重要。与活胎儿共存的CHM很少发生。这种情况是独特的，因为健康的男婴是从具有PMD和CHM的单胎胎盘出生的。
方法：一名34岁的gravida2,para1,living1(G2P1L1)妇女在孕早期因怀疑磨牙妊娠而转诊。MSHCG水平在妊娠早期增加，超声观察多囊性病变和胎盘肿大。水平降至正常，未观察到胎儿结构异常。一名健康的男婴在34孕周分娩。胎盘p57KIP2免疫染色和短串联重复分析揭示了三种不同的组织学和遗传特征：正常婴儿和胎盘，PMD,CHM。诊断为妊娠滋养细胞肿瘤，并进行了四线化疗。
结论：区分PMD和葡萄胎对于避免不必要的终止妊娠至关重要。与活胎儿共存的CHM很少发生。这种情况是独特的，因为健康的男婴是从具有PMD和CHM的单胎胎盘出生的。
