A Molar Pregnancy within the Fallopian Tube

Abstract

Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salpingostomy and special considerations for postoperative care. Case. The patient is a 29-year-old G7P4 who presented with vaginal bleeding in the first trimester and was initially thought to have a spontaneous abortion. Ultrasound was performed due to ongoing symptoms and an adnexal mass was noted. She underwent uncomplicated salpingostomy and was later found to have a partial molar ectopic pregnancy. Conclusion. This case illustrates the rare occurrence of a molar ectopic pregnancy. There was no indication of molar pregnancy preoperatively and this case highlights the importance of submitting and reviewing pathological specimens.

Gestational Trophoblastic Neoplasia after Ectopic Molar Pregnancy: Clinical, Diagnostic, and Therapeutic Aspects

“…18 Less than 300 cases of EMP have been reported over the past 150 years, showing the rarity of the association of this double obstetric complication. [9][10][11] In addition, many of these cases initially reported as EMP were reassessed and later diagnosed as nonmolar pregnancy, with marked villous hydrops. 13,14 The difficulty in correctly diagnosing EMP occurs because morphological abnormalities found during tubal pregnancy appear earlier than those seen in the trophoblastic tissue of miscarriages, at least in later cases.…”

“…However, while salpingotomy is preferred in cases of non-molar ectopic pregnancy, when EMP is suspected, medical professionals have shown a preference for performing salpingectomy, avoiding the possibility of leaving trophoblastic material in the remaining tube. [9][10][11]13,14,25,29 We must insist that because the clinical and ultrasonographic findings of EMP can be non-specific and simulate non-molar ectopic pregnancy, it is extremely important to submit the material obtained during surgery for a histopathological and immunohistochemical study for making an accurate diagnosis. 24 However, as mentioned above, as EMP may mimic nonmolar ectopic pregnancy situations, we must consider that some cases of EMP can be conservatively managed and observe the patient's progress and administer periodic doses of hCG or MTX.…”

Partial Hydatidiform Mole in an Ectopic Tubal Pregnancy

“…Molar should be distinguished by the non-molar pregnancy as the former can cause a persistent trophoblastic disease or even metastasis to distant organs. Hence close follow-up is essential after the removal of products [ 4 ]. In difficult cases, the DNA flow cytometry for ploidy examination and P57 immunocytochemical staining is useful for differentiating partial from complete mole [ 13 ].…”

“…The diagnosis of molar pregnancy at ectopic sites is very difficult as there is no distinguishing clinical feature but depends mainly on the pathology and DNA ploidy analysis [ 3 ]. Although molar pregnancy and ectopic pregnancy are not rare events, the combination of the two, an ectopic molar pregnancy, is an extremely rare event [ 4 ]. Here, we present a case of tubal partial hydatidiform mole that was treated with salpingectomy and accidentally discovered during the histopathological examination, and the case possessed a favorable prognosis.…”

Gestational Trophoblastic Disease Presents as an Ectopic Tubal Pregnancy, a Rare Entity

“…Patients with CHM present with vaginal bleeding, abnormal ultrasound findings, or history of missed abortion. The incidence of ectopic pregnancy is 20 in 1000 and that of hydatidiform molar pregnancy is 1 in 500-1000; nevertheless, the diagnosis of an ectopic molar pregnancy is uncommon with an estimated incidence approximately 1.5 in every 1,000,000 pregnancies [3]. One hundred thirty-two cases of ectopic molar pregnancy of all body sites have been described in a sizable study (1986-2004) [4].…”