A non-trophoblastic tumor co-existing with a triploid fetus

• Published in: Early pregnancy : biology and medicine : the official journal of the Society for the Investigation of Early Pregnancy Vol. 1; no. 1; p. 67
• Main Authors: Pietrantoni, M, Brees, C K, Gerassimides, A, Cook, V, Youkilis, B, Hersh, J H
• Format: Journal Article
• Language: English
• Published: United States 01.03.1995
• Subjects: Abortion, Induced; Adult; Chorionic Gonadotropin, beta Subunit, Human - blood; Female; Fetal Diseases - diagnosis; Fetal Diseases - genetics; Fetal Diseases - pathology; Fetal Growth Retardation; Hemangioma - diagnosis; Hemangioma - genetics; Hemangioma - pathology; Humans; Placenta - pathology; Placenta Diseases - diagnosis; Placenta Diseases - genetics; Placenta Diseases - pathology; Pre-Eclampsia; Pregnancy; Sex Chromosome Aberrations; Trisomy; Ultrasonography, Prenatal
• ISSN: 1354-4195

Non-trophoblastic neoplasms are the most frequent, benign tumors of the placenta, occurring in approximately 1% of all placentas examined. A case is described of a 24-year-old woman who presented with severe, early-onset pre-eclampsia, high human chorionic gonadotropin (hCG) levels, and a triploid fetus and who was found to have a small choriohemangioma. The woman, gravida 2 para 1, was referred to our hospital for perinatal evaluation. The fetus, gestational age 18 weeks 3 days, had fetal growth restriction with multiple congenital anomalies. The fetal karyotype was 69,XXY. Compared with the normal range for this gestational age, the beta-hCG level was significantly elevated (1,054,000 mIU/ml) as was the maternal serum alpha-feto-protein measurement (539.1 ng/ml). Sonographically, the placenta appeared hydropic, irregularly shaped, and gelatinous. A suction dilatation and evacuation under sonographic guidance was performed. Histological examination of placental tissue revealed hydropic degeneration of the chorionic villi. The specific histological features of a partial molar pregnancy were not present. However, there were changes consistent with a choriohemangioma. Flow cytometric DNA analysis performed on formalin-fixed, paraffin-embedded tissue blocks of placenta showed triploidy. Immunohistochemical staining with human placental alkaline phosphatase was consistent with a hydropic degeneration pattern. We conclude, first, that triploidy does not always imply the presence of a partial mole. Second, the dictum, that pre-eclampsia, if it occurs under 20 weeks' gestation, must be associated with a molar pregnancy, may not hold when placental aneuploidy is present. Although the findings in this pregnancy could have been incidental, there may be an association between a choriohemangioma and polyploidy.