National Cancer Institute®
Last Modified: February 1, 2002
UI - 11552718
AU - Liu AY; Chan WY; Ng EK; Zhang X; Li BC; Chow JH; Chung SC
TI - Gastric choriocarcinoma shows characteristics of adenocarcinoma and gestational choriocarcinoma: a comparative genomic hybridization and fluorescence in situ hybridization study.
SO - Diagn Mol Pathol 2001 Sep;10(3):161-5
AD - Department of Anatomical & Cellular Pathology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
The authors report two cases of the rare primary gastric choriocarcinoma. These tumors showed an overwhelming predominance of cytotrophoblast- and syncytiotrophoblast-like tumor cells that were positive for beta-human chorionic gonadotrophin, with small foci of glandular differentiation. Beta-human chorionic gonadotrophin was also detected serologically in one patient. Comparative genomic hybridization study was performed on one specimen. Copy number gains of chromosomes 12, 17, 20, 22, and X, together with losses on 18q, were the major findings. Except for the gain of chromosome 12, which is known to be uncommon in primary gastric adenocarcinoma but frequently associated with choriocarcinoma, the remaining genomic imbalances were among the most common comparative genomic hybridization findings reported in primary gastric adenocarcinoma. Fluorescence in situ hybridization on paraffin sections of both specimens confirmed the presence of polysomy 17 and trisomy 12. These results suggest that primary gastric choriocarcinoma genetically possesses characteristics of both adenocarcinoma and gestational choriocarcinoma. The authors believe this is the first interphase cytogenetics study on this rare tumor, and that the results support the theory that gastric choriocarcinoma arises from alternate differentiation pathways of adenocarcinoma.
UI - 11759139
AU - Celeski D; Micho J; Walters L
TI - Anesthetic implications of a partial molar pregnancy and associated complications.
SO - AANA J 2001 Feb;69(1):49-53
AD - Naval Hospital, Okinawa, Japan.
In the United States, molar pregnancy occurs between 1 in 1,200 and 1 in 2,500 pregnancies. The critical nature of complications associated with a molar pregnancy requires advanced perioperative anesthetic management. This case report details the perioperative events of a 34-year-old gravida 5, para 3, with a partial molar pregnancy who underwent general anesthesia for a dilatation and curettage procedure, following therapeutic termination of a coexisting fetus at 18 weeks' gestation. Her initial presentation, anesthetic and operative management, and postoperative course are described clearly. The medical and anesthetic interventions required for treatment of molar pregnancy are reviewed. Of molar pregnancies, 80% are uncomplicated and follow an unremarkable course. However, for the remaining 20%, complications can be severe and may lead to substantial morbidity and mortality in otherwise healthy women.
UI - 11769671
AU - Cui Z; Xiang Y; Yang X
TI - [Establishment of the drug resistant cell line of choriocarcinoma and the reversal of drug resistance by transfection of human interleukin 2 gene]
SO - Zhonghua Fu Chan Ke Za Zhi 2001 Sep;36(9):549-53
AD - Department of Gynecology, Affiliated Hospital, Medical College of Qingdao University, Qingdao 266003, China.
OBJECTIVE: To establish the drug-resistant cell line of choriocarcinoma and to study the transfection of the human interleukin 2 (hIL-2) gene into the established drug resistant cell line and investigate the reversal of the multidrug resistance. METHODS: The resistant cell line was established by pulse exposed choriocarcinoma cell line JEG-3 to etopside (VP-16) for ten months. The recombinant plasmid containing pcDNA3.1(+)-hIL-2 gene was constructed. The drug resistant cell line was transfected with the constructed plasmid by lipofectin, and the tumor cell colonies containing the IL-2 sequence were selected by genetin. The expression of hIL-2 and drug resistant-related genes was detected by reverse transcript polymerase chain reaction. The chemosensitivity of the gene-transfected tumor cells and the non transfected cell lines to methetraxate, VP-16, kengshengmycine, paclitaxol and 5-fluorouracil was determined by the methyl thiazolyl tetrazolium cytotoxicity assay. RESULTS: The transfected cells expressed human hIL-2 gene, and showed the reversal of multidrug resistance by methyl thiazolyl tetrazolium assay. The transfected cells expressed no multidrug resistance gene-1 (MDR1) on mRNA level. Drug resistance index to VP-16 decreased from 38.7 to 6.0 and 6.1, the index to methetraxate decreased from 14.5 to 2.6 and 2.5, to methetraxate from 13.0 to 2.0. CONCLUSION: The transfection of hIL-2 gene into the drug resistance cell line of choriocarcinoma can modulate the MDR1 expression on the mRNA level, and reverse the drug resistance.
UI - 11587021
AU - Curtin WM; Marcotte MP; Myers LL; Brost BC
TI - Trisomy 13 appearing as a mimic of a triploid partial mole.
SO - J Ultrasound Med 2001 Oct;20(10):1137-9
AD - Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo, USA.
UI - 11603223
AU - Kommoss F; Schmidt D; Coerdt W; Olert J; Muntefering H
TI - Immunohistochemical expression analysis of inhibin-alpha and -beta subunits in partial and complete moles, trophoblastic tumors, and endometrial decidua.
SO - Int J Gynecol Pathol 2001 Oct;20(4):380-5
AD - Institut fur Pathologie, A 2, 2, 68159 Mannheim, Germany.
The expression of inhibin-alpha subunit has been described in normal placentas, hydatidiform moles, and trophoblastic tumors. We performed a double immunohistochemical expression analysis of inhibin-alpha and inhibin-beta subunits in a cytogenetically well characterized series of 21 complete and 22 partial hydatidiform moles, 2 placental site trophoblastic tumors, and one choriocarcinoma. Syncytiotrophoblastic cells were consistently inhibin-alpha and inhibin-beta positive in all hydatidiform moles and in the one choriocarcinoma. Cytotrophoblast was negative for both subunits in all trophoblastic lesions studied. While villous intermediate trophoblastic cells were consistently inhibin-alpha negative in all hydatidiform moles, focal inhibin-beta immunoreactivity was detected in villous intermediate trophoblast in approximately one third of complete and partial hydatidiform moles. Decidual stromal cells in 40 hydatidiform moles were inhibin-alpha and inhibin-beta positive in approximately one third of cases. Both placental site trophoblastic tumors were inhibin-alpha positive but inhibin-beta negative. Our findings indicate that inhibin-alpha and -beta subunits are consistently coexpressed in syncytiotrophoblast in complete and partial moles. Immunohistochemical detection of inhibin subunits may be useful in the differential diagnosis of trophoblastic lesions.
UI - 11759958
AU - Benjapibal M; Wataganara T; Senawong S; Boriboonhirunsarn D; Suphanit I
TI - The correlation of beta-subunit human chorionic gonadotropin level in the serum and first morning urine of patients with gestational trophoblastic disease.
SO - J Med Assoc Thai 2001 Jul;84(7):1000-5
AD - Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
The purpose of this cross-sectional study was to determine the correlation of beta subunit human chorionic gonadotropin (beta-hCG) level in the serum and first morning urine samples of patients with gestational trophoblastic disease (GTD). A total of 81 paired serum and first morning urine samples from 24 patients diagnosed with GTD, who had their follow-up at the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University. The paired serum and first morning urine samples were measured for beta-hCG level, using enzyme-linked immunosorbent assay (ELISA). After logarithmic transformation, serum beta-hCG level was strongly and significantly correlated to those of first morning urine samples, with the correlation coefficient of 0.97 (p < 0.01). Among the disease-remission group (serum beta-hCG of less than 5 mIU/ml), the correlation coefficient was 0.52 (p < 0.01), which was still statistically significant. Stronger statistical significance was found in the disease-active group (serum beta-hCG of 5 mIU/ml or higher), with the correlation coefficient of 0.95 (p < 0.01). We concluded that the level of serum beta-hCG was strongly and significantly correlated with those of first morning urine samples, especially in patients with active disease. Determination of beta-hCG level using first morning urine samples can be used as an effective mean in the follow-up of patients with GTD.
UI - 11422477
AU - Burton JL; Lidbury EA; Gillespie AM; Tidy JA; Smith O; Lawry J; Hancock
TI - BW; Wells M Over-diagnosis of hydatidiform mole in early tubal ectopic pregnancy.
SO - Histopathology 2001 May;38(5):409-17
AD - Section of Oncology and Pathology, Division of Genomic Medicine, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK. email@example.com
AIMS: Tubal ectopic hydatidiform moles are rare lesions, and only 40 cases have been reported in the world literature. We investigated the apparently high incidence of tubal ectopic hydatidiform moles in women referred for treatment to a Supraregional Trophoblastic Tumour Screening and Treatment Centre between 1986 and 1996. METHODS AND RESULTS: Of 4261 women referred during the study period, 25 (0.6%) had a suspected tubal ectopic hydatidiform mole and paraffin-embedded tissue was available in 20 (80%) of these. Each case was reviewed by two pathologists and DNA flow cytometric analysis was undertaken when the histological diagnosis was initially deemed equivocal or suggestive of hydatidiform mole. On review, 17 cases (85%) showed no evidence of hydatidiform mole (circumferential trophoblastic proliferation, hydrops, scalloped villi, and stromal karyorrhexis). Of these, 11 cases (65%) showed features of early placentation and six (35%) showed hydropic abortion. DNA flow cytometry was performed in 14 (82%) of these cases and revealed a diploid population in each case. Three cases of molar pregnancy (15%) were identified. Each of these cases had the histological features of an early complete hydatidiform mole. Sufficient tissue was available for DNA flow cytometric analysis in two of these cases and confirmed the presence of diploidy in each. CONCLUSION: Our results show that tubal ectopic hydatidiform mole is a rare entity and demonstrate that it is over-diagnosed. Polar trophoblastic proliferation and hydropic villi are features of early placentation and of hydropic abortion. Sheets of extravillous trophoblast may be particularly prominent in tubal ectopic gestation. In the absence of circumferential trophoblastic proliferation combined with hydropic change a diagnosis of gestational trophoblastic disease should be avoided.
UI - 11532043
AU - Rees HC; Paradinas FJ
TI - The diagnosis of hydatidiform mole in early tubal ectopic pregnancy.
SO - Histopathology 2001 Sep;39(3):320-1
AD - Charing Cross Department of Histopathology, The Hammersmith Hospitals NHS Trust, London, UK.
UI - 11695810
AU - Su WH; Wang PH; Chang SP
TI - Successful treatment of a persistent mole with myometrial invasion by direct injection of methotrexate.
SO - Eur J Gynaecol Oncol 2001;22(4):283-6
AD - Department of Obstetrics and Gynecology, Yee-Zen General Hospital, Tao-Yuan, Taiwan.
For patients with persistent or invasive gestational trophoblastic disease (GTD), systemic injection of chemotherapy is the treatment of choice if fertility is to be preserved. To prevent serious adverse effects after systemic use and possibly achieve better effects, direct local injection of chemotherapy into the tumor site, especially when in the myometrium, seems a reasonable alternative. A patient with a persistent molar pregnancy with myometrial invasion is presented. A plateau of beta-hCG (human chorionic gonadotropin) level around 550 mIU/mL was noticed for three weeks though systemic methotrexate (MTX) injection and repeat suction curettage had been performed. During the same period, a well-defined invasive complex with multiple vesicles in the myometrium was documented using transvaginal ultrasound (TVUS). Sonar-guided injection to the tumor using 50 mg MTX was performed uneventfully. An obvious shrinkage of the mass and declining beta-hCG level were demonstrated after the procedure. The patient restored her menses after the operation and a fertility evaluation including serial beta-hCG levels and hysterosalpingography showed them to be within the reference ranges. The successful outcome of this case encouraged us to treat localized invasive GTD using direct injection of MTX with the guidance of TVUS. Since no identical cases were found in our review of the English literature, more cases and similar regimens are needed to establish the safety and efficacy of this procedure.
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