Villous oedemaLack of vesselsCircumferential trophoblastic hyperplasiaFjord-like outline of villiVessels present contain nucleated RBCsLess prominent trophoblastMaternally expressed gene product p57 is positiveSerum human hCGElevatedLess elevatedRisk of choriocarcinomaAbout 2%Rare
hCG = human chorionic gonadotrophin | RBC = red blood cells
Invasive mole or chorioadenoma destruens This is a rare condition where the chorionic invades the myometrium. There is vascular involvement and, although the villi can be transported to distant sites, they are not capable of growing at the distant sites.
Choriocarcinoma This is a very rare malignancy with a marked propensity to vascular dissemination and the favoured sites of metastases are lungs, vagina and brain. The malignancy is very sensitive to chemotherapy.
Tumours of extravillous or placental site trophoblast
Placental site nodule This is a benign condition where hyalinised nodules of intermediate type or placental site trophoblast continue to remain in the endometrial lining. It can result in persistent bleeding.
Placental site trophoblastic tumour This is a rare malignant tumour of placental site or intermediate trophoblast. About 10% of these tumours result in metastases and death. In contrast to diseases of villous trophoblast where the serum human chorionic gonadotrophin (hCG) was raised, the marker is human placental lactogen (HPL).
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