Page 536 - Concise Pathology for Exam Preparation ( PDFDrive )

18 Female Genital System 521

Q. Differentiate between H. mole and choriocarcinoma.
Ans. Differences between H. mole and choriocarcinoma are listed in Table 18.5.

TABLE 18.5. Differences between H. mole and choriocarcinoma
Features H. mole Choriocarcinoma
Definition Variable trophoblastic proliferation, mostly Choriocarcinoma is a malignant neoplasm of
benign in nature. May give rise to chorio- trophoblastic cells derived from any form of
carcinoma previously normal or abnormal pregnancy
Presentation During 12–14 weeks of pregnancy, patient During pregnancy or after miscarriage, patient
presents with vaginal bleeding/passage of presents with bloody, brown, foul-smelling
grape-like structures discharge
Gross Delicate, friable mass of thin-walled, trans- Soft, fleshy, with extensive haemorrhage and
lucent, cystic and grape-like structures areas of necrosis
Microscopy Villous oedema with absence of vascularity, Epithelial malignancy; chorionic villi not
cytotrophoblast and syncytiotrophoblast formed; abnormal proliferation of both
cover villi cytotrophoblast and syncytiotrophoblast
Uterus size Much larger than expected for that duration Mild enlargement
of pregnancy
HCG level h hhh
Precedent history None H. mole, abortion, normal/ectopic pregnancy
Metastasis Not seen To lung, liver and brain
Treatment Curettage Curettage and chemotherapy; may be
hysterectomy

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