Epidemiological and morphological pattern of complete hydatidiform mole in Aminu Kano Teaching Hospital, Kano Northwestern Nigeria

Abstract

Background: Complete hydatidiform mole (CHM) is the most common form of non-neoplastic gestational trophoblastic diseases (GTD) that is associated with progression to choriocarcinoma without prompt intervention. The objectives of this study is to morphologically analyze all cases of complete hydatidiform mole in Aminu Kano Teaching Hospital using set down criteria, look at the epidemiological pattern and compare with similar studies in order to stimulate proper identification from other forms of moles, hence reduce morbidity and mortality associated with the known complication of progressing to deadly Choriocarcinoma. Material and Methods: This was a retrospective study of all molar specimens submitted to Histopathology Pathology Department of Aminu Kano Teaching Hospital, Kano between 1st January 2015 and 31st December 2016. Formalin-fixed paraffin-embedded tissue blocks and corresponding Haematoxylin and Eosin (H&E) stained slides were retrieved. Cases with final diagnosis of complete mole were selected for further detailed microscopic evaluations. The collected data were presented using simple frequency tables and figures including photomicrographs of representative lesions. Results: There were sixty-seven cases of complete hydatidiform mole during the study period out of the 61,780 deliveries, giving an approximate incidence of 1:1000 deliveries in Kano metropolis and its environs. The peak incidence was observed in women between 20- 24 years of age with majority presenting between 11-14weeks of pregnancy. The ratio of complete to partial mole was approximately 3:1. Constant morphologic features associated with CHM includes; villous enlargement, trophoblastic hyperplasia, round shape chorionic villi and fibromyxoid stroma. Least prominent feature of CHM is myxoid stromal type. Conclusion: Complete hydatidiform occurs commonly in the gestational ages of between eleven to fourteen weeks; need histopathologic evaluations and prompt intervention to avoid consequences of both immediate complication such as invasive mole and long-term complication of choriocarcinoma. Keywords: Hydatidiform Mole, Complete Mole, Choriocarcinoma