title: [Twin pregnancy with both complete hydatiform mole and coexistent alive fetus: report of a non-antenatal diagnosed case].
abstract: Twin pregnancy with both complete hydatiform mole and coexistent fetus is a rare situation and a challenging diagnosis. We report an unusual case of twin pregnancy with complete mole diagnosed after pathological examination of the placenta. A 30-year-old woman, 14 weeks gestation, presented with vaginal bleeding. The abdominal ultrasound examination revealed an heterogeneous aspect of inferior placenta, which was interpreted as a hematoma, and, a multilacunar placental aspect with an oligoamnios respectively at initial follow-up and 22 weeks gestation. The karyotype from chorionic villi was normal (46 XY). At 25 weeks, after a spontaneous abortion, she delivered a 950g newborn who died quickly. On placental gross examination two distinct but connected masses were identified: one exhibited a normal placental aspect and the other vesicular villi with necrotic and hemorrhagic fragments. On microscopic examination, the normal placenta showed well-developed chorionic villi and the multicystic placenta showed molar villi. Immunohistochemical study and fluorescence in situ hybridization confirmed a complete hydatiform mole. No persistent gestational trophoblastic neoplasia was observed during the follow-up.
authors.affiliation: Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, Grande-Rue de-la-Croix-Rousse, 69317 Lyon cedex 04, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Chesnais
authors.forename: Frédérique
authors.initials: F
authors.lastname: Le Breton
authors.forename: Mojgan
authors.initials: M
authors.lastname: Devouassoux-Shisheboran
authors.forename: Cyril
authors.initials: C
authors.lastname: Huissoud
authors.forename: Jérôme
authors.initials: J
authors.lastname: Massardier
authors.forename: Benoit
authors.initials: B
authors.lastname: Quilichini
authors.forename: Fabienne
authors.initials: F
authors.lastname: Allias
mesh_terms: D000328:Adult; D015193:Chorionic Villi Sampling; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D004200:Diseases in Twins; D005188:False Negative Reactions; D017809:Fatal Outcome; D005260:Female; D006406:Hematoma / Q000175:diagnosis; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D017404:In Situ Hybridization, Fluorescence; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D050498:Live Birth; D008297:Male; D008796:Metrorrhagia / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000209:etiology; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D059285:Pregnancy, Twin; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology