Gestational Trophoblastic Disease

Frank H Miller, MD
Faye C Laing, MD

June 8, 1994

Presentation

Imaging Findings

Ultrasound examination shows an enlarged uterus but no fetal parts. Echogenic material with scattered small cysts fills the uterine cavity (noted by marked area). The ovaries are bilaterally enlarged and contain multiple peripheral cysts (arrows).

Diagnosis

Discussion

Gestational trophoblastic disease comprises a spectrum that includes benign hydatiform mole (90%), invasive mole (5-8%), and choriocarcinoma (1-2%). Sonographic findings within the pelvis may be identical with these three conditions.

Typical sonographic findings include uterine enlargement with the cavity filled by an echogenic mass of multiple small hypoechoic cysts. Bilateral theca lutein cysts are visible in 20-50% of cases and are due to ovarian stimulation by elevated levels of circulating human chorionic gonadotropin.

Pathology findings include marked edema and enlargement of chorionic villi, disappearance of villus blood vessels, proliferation of the lining trophoblast of the chorionic villi, and absence of fetal tissue.

References

2. Reid MH, McGahan JP, Oi R. Sonographic evaluation of hydatiform mole and its look-alikes. AJR 1983;140:307-311.

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