PDF(Pubmed)
Abstract：
Twin pregnancy with a complete hydatidiform mole and coexisting fetus (CHMCF) is an exceedingly rare condition with an incidence of about 1 in 20,000-100,000 pregnancies. It can be detected by prenatal ultrasonography and an elevated maternal serum beta-human chorionic gonadotropin (BhCG) level. Herein, the author reports a case of CHMCF which was incidentally diagnosed through pathologic examination without preoperative knowledge. The 41-year-old woman, transferred due to preterm labor, delivered a female baby by cesarean section at 28 + 5 weeks of gestation. Clinically, the surgeon suspected placenta accreta on the surgical field, and the placental specimen was sent to the pathology department. On gross examination, focal vesicular and cystic lesions were identified separately from the normal-looking placental tissue. The pathologic diagnosis was CHMCF and considering the fact that placenta accreta was originally suspected, invasive hydatidiform mole was not ruled out. After radiologic work-up, metastatic lung lesions were detected, and methotrexate was administered in six cycles at intervals of every two weeks. The author presents the clinicopathological features of this unexpected CHMCF case accompanied by pulmonary metastasis, compares to literature review findings, and emphasizes the meticulous pathologic examination.
摘要：
具有完全葡萄胎和共存胎儿（CHMCF）的双胎妊娠是一种极为罕见的疾病，发生率约为20,000-100,000妊娠中的1。可以通过产前超声检查和母体血清β-人绒毛膜促性腺激素（BhCG）水平升高来检测。在这里，作者报告了1例CHMCF，在没有术前知识的情况下，通过病理检查偶然诊断。那个41岁的女人,由于早产而转移，在妊娠28+5周时通过剖宫产分娩了一名女性婴儿。临床上,外科医生怀疑胎盘在手术区域植入，胎盘标本送到病理科。粗略检查，局灶性囊泡和囊性病变与正常胎盘组织分开鉴定.病理诊断为CHMCF，并考虑到最初怀疑胎盘植入的事实，不排除侵袭性葡萄胎。放射学检查后，检测到肺转移性病变，甲氨蝶呤分6个周期给药，每2周一次。作者介绍了该例伴有肺转移的CHMCF患者的临床病理特征。与文献综述的发现相比，并强调细致的病理检查。
