Choriocarcinoma of the Fallopian tube

Clinicopathologic features of gestational trophoblastic neoplasia in the Limpopo Province, South Africa

The pathogenesis of gestational trophoblastic neoplasia (GTN) is complex; various etiological factors influence the wide variety of its distribution throughout the world. Gestational trophoblastic neoplasia encompasses a spectrum of benign and malignant lesions. The relative prevalence of benign versus malignant cases varies geographically. Most GTNs are benign and located in the uterus; benign and malignant GTNs do also arise outside the uterine body. Tubal hydatid moles (HMs) and primary choriocarcinomas are rare. Over a 3-year period, 119 cases of biopsy-diagnosed GTNs were prospectively collected: 70.6% were benign and 29.4% were malignant. Two HMs, or 2.4% of all HMs, were located in the tubes; 2 choriocarcinomas, or 6.5% of all malignant GTNs, originated in the tubes. Tubal GTNs accounted for 0.5% of 857 tubal ectopic pregnancies. There was no significant difference in the mean age of benign and malignant GTNs (P = 0.61). Four (11.4%) of the 35 malignant GTNs were HIV infected.

Choriocarcinome tubaire: à propos d'un cas et revue de la littérature

The authors describe a case report of a tubal choriocarcinoma occurring in women of 32 years old, 2 years after her last pregnancy. The patient was treated by laparoscopic salpingectomy and polychemotherapy. Metastatic pulmonary micronodules were diagnosed at thoraco-abdomino-pelvic tomodensitometry. Patient's recovery was complete with an uneventfull follow-up at 3 years. The association of surgical treatment and chemotherapy used under the guidelines of the FIGO score improves patient's outcome.

Overdiagnosis of Complete and Partial Hydatidiform Mole in Tubal Ectopic Pregnancies

Partial or complete hydatidiform mole (HM) affects approximately 1 in 500 to 1,000 pregnancies. Previous small series suggest that histopathologic diagnosis of HM may be difficult in tubal ectopic pregnancies. The histopathology database of a regional Trophoblastic Disease Unit was searched to identify cases with a referral diagnosis of tubal HM, and the histopathologic findings were reviewed. During the study period (1986-2004 inclusive), there were 132 cases. After central review by specialist histopathologists, the final diagnosis was ectopic partial mole in two, ectopic complete mole in five, and ectopic hydatidiform mole (not otherwise specified) in one. The final diagnosis of definite hydatidiform mole was made in eight (6%) cases, significantly less than in referred uterine curettage specimens, in which approximately 90% have a confirmatory diagnosis of HM (Z = 12.9; p < 0.0001). No cases in this series developed persistent gestational trophoblastic disease, the human chorionic gonadotropin concentration spontaneously returning to normal. Ectopic pregnancies, where managed surgically, should be submitted for histopathologic examination; however, the pathologist should be aware that the degree of extravillus trophoblastic proliferation may appear more florid compared with evacuated uterine products of conception. Molar pregnancy should only be diagnosed when strict criteria regarding morphologic abnormalities previously described in uterine evacuation material are applied.