title: Rare case of peritoneal complete hydatidiform mole.
abstract: A 23-year-old woman, gravida 1, para 1, was transferred to our hospital with acute lower abdominal pain and vital signs consistent with shock. Her urine concentration of human chorionic gonadotrophin was 8000 mIU/mL. Transvaginal ultrasound revealed an echo-free space with mosaic echo pattern in the right adnexal area and no gestational sac in the uterus. With a preoperative diagnosis of ruptured ectopic pregnancy, emergency laparotomy was performed. The rectouterine pouch was filled with many clots containing small amounts of villous tissue. After removal of the conceptus, which was infiltrating into the peritoneum of the Pouch of Douglas, bleeding was controlled by Argon laser. Histological examination of the conceptus by immunohistochemical staining with p57(kip2) showed features of complete hydatidiform mole. This case demonstrates that the peritoneum in the Pouch of Douglas is a possible site of ectopic complete hydatidiform mole occurrence and that immunohistochemical stain is useful to confirm the diagnosis of ectopic complete hydatidiform mole.
authors.affiliation: Department of Obstetrics and Gynecology, Hadano Red Cross Hospital, Kanagawa, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Ota
authors.forename: Chikara
authors.initials: C
authors.lastname: Oda
authors.forename: Masaki
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takao
authors.initials: T
authors.lastname: Mikoshiba
authors.forename: Miki
authors.initials: M
authors.lastname: Kushima
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003937:Diagnosis, Differential; D004312:Douglas' Pouch; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000000981:diagnostic imaging; D012769:Shock / Q000209:etiology; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Pouch of Douglas; complete hydatidiform mole; immunohistochemical stain; peritoneal pregnancy; ultrasound