Obeidi Nedaa, Tchrakian Nairi, Abu Saadeh Feras, Mocanu Edgar
Human Assisted Reproduction Ireland, Dublin, Ireland.
Department of Histopathology, Rotunda Hospital, Dublin, Ireland.
BMJ Case Rep. 2015 Apr 2;2015:bcr2015209353. doi: 10.1136/bcr-2015-209353.
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.
一名32岁的原发性不孕患者接受了体外受精（IVF）治疗。四周后，她出现间歇性左下腹疼痛。经阴道超声显示子宫内为空，右侧卵巢旁有一个附件包块。血清β-人绒毛膜促性腺激素为33492IU/L。在腹腔镜检查中，切除了一个附着在右侧卵巢上的包块，提示右侧卵巢异位妊娠。组织学检查证实为卵巢异位妊娠，但发现绒毛膜绒毛增大和滋养细胞异型性，这引起了葡萄胎妊娠的怀疑。然而，随后的p57免疫组化和DNA倍体研究排除了葡萄胎。异位妊娠中疑似葡萄胎疾病的病例对临床医生和组织病理学家来说都是一个诊断挑战，确定明确的诊断可能很困难。
