- Early complete moles are important to identify due to the risk of post molar tumors including choriocarcinoma.
- Morphologic assessment for cavitated villi with focal and diffuse hyperplasia of trophoblast, fibroadenoma like mesenchymal stroma and irregular villous contours resembling knuckles or toes is important.
- The differential diagnosis includes hydropic abortus, partial mole, and an intact gestational sac mimicking a single cavitated villous.
- Pure morphologic examination can sometimes be problematic
- p57KIP2 has been shown to effectively distinguish between complete moles and its mimics, including partial mole.
- This protein is paternally imprinted and only expressed from maternal derived chromosomes.
Therefore, complete moles (which are a product of diandry), will be consistently negative, while decidua (maternal derived tissue) will show nuclear positivity serving as an internal control.
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Photos (A),( B), and (C) are from hydropic villi. (D) is taken from a early complete mole. |