title: Suspected ovarian molar pregnancy after assisted reproductive technology conception: a diagnostic challenge.
abstract: A 32-year-old patient with primary infertility received in vitro fertilisation (IVF) therapy. Four weeks later she developed intermittent left iliac fossa pain. Transvaginal ultrasound showed an empty uterus and an adnexal mass adjacent to the right ovary. Serum β-human chronic gonadotropin was 33,492 IU/L. At laparoscopy a mass attached to right ovary, suggestive of a right ovarian ectopic pregnancy, was excised. Histological examination confirmed an ovarian ectopic gestation, but noted enlarged chorionic villi and trophoblastic atypia, which raised the suspicion of molar pregnancy. Subsequent p57 immunohistochemistry and DNA ploidy studies excluded a mole, however. Cases of suspected molar disease in ectopic pregnancy present a diagnostic challenge for both clinicians and histopathologists, and establishing a definitive diagnosis may be difficult.
authors.affiliation: Human Assisted Reproduction Ireland, Dublin, Ireland.
authors.forename: Nedaa
authors.initials: N
authors.lastname: Obeidi
authors.affiliation: Department of Histopathology, Rotunda Hospital, Dublin, Ireland.
authors.forename: Nairi
authors.initials: N
authors.lastname: Tchrakian
authors.affiliation: St. James's Hospital, Dublin, Ireland.
authors.forename: Feras
authors.initials: F
authors.lastname: Abu Saadeh
authors.affiliation: Royal College of Surgeons, Ireland.
authors.forename: Edgar
authors.initials: E
authors.lastname: Mocanu
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000473:pathology; D010535:Laparoscopy; D010053:Ovary / Q000473:pathology*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D014463:Ultrasonography
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