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[双胎妊娠合并完全性葡萄胎及共存活胎:一例病例报告并文献复习]

[Twin gestation with complete hydatidiform mole and a coexisting live fetus: A case report and review of the literature].

作者信息

Moscoso Olivier, Camacho Jessica, García-Ruiz Itziar, Madureira Joana, Navarro Alexandra, Ramón Y Cajal Santiago, Garrido-Pontnou Marta, Reques Armando

机构信息

Servicio de Anatomía Patológica, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, España.

Servicio de Obstetricia y Ginecología, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, España.

出版信息

Rev Esp Patol. 2022 Sep;55 Suppl 1:S21-S26. doi: 10.1016/j.patol.2020.06.008. Epub 2020 Sep 2.

Abstract

Twin pregnancies with complete hydatidiform mole and coexisting live fetus are very rare, with only about 300 reported cases. This type of pregnancy is considered a high obstetric risk due to the possibility of severe maternal-fetal complications. Although the clinical and ultrasound findings can be highly suggestive of this type of pregnancy, the definitive diagnosis is usually reached by histopathological examination. The differential diagnosis usually includes partial hydatidiform mole and hydropic pregnancies, which can present similar findings in specimens from the first trimester of pregnancy and thus it is important to interpret correctly the differentiating features. The use of immunohistochemistry for p57 can prove very useful, although some cases show an aberrant expression. We present a case of a twin pregnancy with complete hydatidiform mole associated with a live fetus, with magnetic resonance imaging and ultrasound for radiopathological correlation. We discuss the differential diagnosis and the utility of p57 immunohistochemistry.

摘要

双胎妊娠中完全性葡萄胎与并存活胎的情况极为罕见,仅报道过约300例。由于可能出现严重的母胎并发症,这种类型的妊娠被视为高产科风险。尽管临床和超声检查结果可能高度提示此类妊娠,但确诊通常需通过组织病理学检查。鉴别诊断通常包括部分性葡萄胎和水肿性妊娠,它们在妊娠早期标本中可能呈现相似表现,因此正确解读鉴别特征很重要。尽管有些病例显示p57表达异常,但使用p57免疫组化可能非常有用。我们报告一例双胎妊娠,其中完全性葡萄胎与活胎并存,并进行了磁共振成像和超声检查以进行放射病理学对照。我们讨论了鉴别诊断及p57免疫组化的效用。

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