Spectrum of sonographic findings in gestational trophoblastic disease

Abstract

Objective: The aims of this study were: to evaluate the spectrum of sonographic findings in patients with gestational trophoblastic disease; and to determine the accuracy of sonography in the evaluation of patients with possible gestational trophoblastic disease. Methods: A retrospective review of all pathologically proven cases of molar pregnancy (partial and complete) in the past 10 years at two institutions was performed. Patients with preoperative sonograms were selected, and the sonographic findings were correlated with the histologic diagnosis. The quantitative beta-hCG level at the time of diagnosis, patients’ presenting symptoms, if any, and any available follow-up were obtained from chart review. Results: We identified 37 patients with path proven gestational trophoblastic disease. Of these, 24 had histologic diagnosis of complete molar pregnancy and 13 had histologic diagnosis of partial molar pregnancy. The sonographic reports were accurate in 84% of cases in the diagnosis or suggesting the diagnosis of a molar pregnancy. There were 5 cases of partial molar pregnancies who had preoperative sonographic diagnosis of either failed intrauterine pregnancy (2), viable intrauterine pregnancy (2), and hydropic placenta (1). There was one case of complete molar pregnancy who had a preoperative sonographic diagnosis of failed intrauterine pregnancy. One patient with complete mole was overdiagnosed as having persistent trophoblastic neoplasia. Conclusions:Sonography plays an important role in the preoperative diagnosis of molar pregnancy, either complete or partial. The diagnosis of molar pregnancy should be considered even when the characteristic complex endometrial collection or theca lutein cysts are not seen.