J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 12, December 2015, pages 961-966

The Diagnosis of Choriocarcinoma in Molar Pregnancies: A Revised Approach in Clinical Testing

**Table 1.** A Comparison of the Characteristics of Partial and Complete Moles (Derived From [5])
Characteristic	Partial mole	Complete mole
Development	Some fetal development but malformed	No fetal development (cord, membrane present)
Villi	Some enlarged; two populations of villi Blood vessels and fetal red blood cells present Scalloped outlines with pseudoinclusions and invaginations Focal trophoblast proliferation Minimal trophoblast atypia	All enlarged Blood vessels absent Round to ovoid Prominent cisterns Circumferential trophoblastic proliferation Trophoblast atypia present
Origin	Both maternal and paternal	Paternal only
Genetics	Triploid	Diploid (or tetraploid)
p57 IHC stain	Positive	Negative

Table 1. A Comparison of the Characteristics of Partial and Complete Moles (Derived From [5])

Characteristic

Partial mole

Complete mole

Development

Some fetal development but malformed

No fetal development (cord, membrane present)

Villi

Some enlarged; two populations of villi
Blood vessels and fetal red blood cells present
Scalloped outlines with pseudoinclusions and invaginations
Focal trophoblast proliferation
Minimal trophoblast atypia

All enlarged
Blood vessels absent
Round to ovoid
Prominent cisterns
Circumferential trophoblastic proliferation
Trophoblast atypia present

Origin

Both maternal and paternal

Paternal only

Genetics

Triploid

Diploid (or tetraploid)

p57 IHC stain

Positive

Negative

**Table 2.** Referral Reasons for Ploidy Testing Based on Morphology Compared to the Final Diagnosis Using FISH
	Initial referral reason
Final diagnosis
Molar pregnancy	40	5	12	57
Hydropic pregnancy	23	30	69	122
Other	7	4	8	19
Percentage correctly diagnosed (%)	57.1%	87.2%	86.5%

Table 2. Referral Reasons for Ploidy Testing Based on Morphology Compared to the Final Diagnosis Using FISH

Initial referral reason

Molar pregnancy referral (n = 70)

Exclude molar pregnancy referral (n = 39)

Hydropic/Other referral (n = 89)

Total (n = 198)

Final diagnosis

Molar pregnancy

Hydropic pregnancy

122

Other

Percentage correctly diagnosed (%)

57.1%

87.2%

86.5%

**Table 3.** A Summary of the Cases Showing Atypical p57 IHC Staining Patterns
Category	P57 stain	Sex	Other abnormality?	Maternal genome status and possible causal mechanism
Complete mole	Positive	XX	No	Present - retained maternal chromosome 11/trisomic rescue
Partial mole	Negative	XXY	Triploid	Absent - dispermy or mutation in maternal p57 allele
	Negative	XXX	Triploid	Absent - dispermy or mutation in maternal p57 allele
	Positive	XX	No	Present - biparental mole
	Negative	XXY	Triploid	Absent - dispermy or mutation in maternal p57 allele
	Negative	XXY	Triploid	Absent - dispermy or mutation in maternal p57 allele
Hydropic	Negative	XY	T18	Absent - dispermy, biparental mole or mutation in maternal p57 allele
	Negative	XX	T21	Absent - dispermy, biparental mole or mutation in maternal p57 allele
	Negative	XY	No	Absent - dispermy, biparental mole or mutation in maternal p57 allele
Other	Negative	XX	No	Absent - dispermy, biparental mole or mutation in maternal p57 allele

Table 3. A Summary of the Cases Showing Atypical p57 IHC Staining Patterns

Category	Sex complement	Number of cases	p57 stain
Complete mole (p57-)	XX	8	One case atypical (p57+): focally positive staining in the cytotrophoblast
	XY	0
Partial mole (p57+)	XXY	14	Three cases atypical: two were p57 negative, and one showed absent staining in the basal cytotrophoblast
	XYY	1	Suboptimal
	XXX	3	One case atypical: p57 negative
	XX	1	One case: p57 positive
Total		27	7