Subject(s)
Eyebrows/physiopathology , Keratoacanthoma/diagnosis , Lip/physiopathology , Aged , Eyebrows/abnormalities , Eyebrows/pathology , Female , Humans , Hydatidiform Mole, Invasive/etiology , Hydatidiform Mole, Invasive/physiopathology , Keratoacanthoma/physiopathology , Lip/abnormalities , Lip/pathology , Male , PregnancyABSTRACT
OBJECTIVE: The purpose of this study was to compare gestational trophoblastic disease incidence rates with the use of population-based data. STUDY DESIGN: All incident cases between 1973 and 1997 and live birth, pregnancy, and women at risk were tabulated with the use of data that were derived from the New Mexico Tumor Registry and Vital Records and Health Statistics Annual Reports. Statistical methods included trends analyses, odds ratios, and Poisson regression. RESULTS: Of 939 total cases, 312 non-Hispanic white women, 399 Hispanic white women, 201 American Indian women, and 27 other women were affected. Age-adjusted incidence rates were significantly higher for American Indian women (11.16%) compared with non-Hispanic (3.57%) or Hispanic white women (5.32%); the probability value was <.001. When live birth (1:438 women) and pregnancy (1:486 women) denominators were considered, American Indian women alone were at increased risk, and the ratio increased by 56% over 25 years. American Indian women were also at increased risk for partial mole (relative risk, 4.03; 95% CI, 2.57-6.31), invasive mole (relative risk, 26.7; 95% CI, 7.81-93.14), and choriocarcinoma (relative risk, 6.29; 95% CI, 1.81-22.66) variants. CONCLUSION: American Indians are at increased risk relative to the other predominant ethnic groups in New Mexico. Age-adjusted standardization provided a reproducible measurement that may be applicable across other registries.
Subject(s)
Gestational Trophoblastic Disease/ethnology , Gestational Trophoblastic Disease/etiology , Hispanic or Latino/statistics & numerical data , Indians, North American/statistics & numerical data , White People/statistics & numerical data , Adolescent , Adult , Child , Choriocarcinoma/ethnology , Choriocarcinoma/etiology , Female , Humans , Hydatidiform Mole/ethnology , Hydatidiform Mole/etiology , Hydatidiform Mole, Invasive/ethnology , Hydatidiform Mole, Invasive/etiology , New Mexico/epidemiology , Pregnancy , Risk Assessment , Risk Factors , Uterine Neoplasms/ethnology , Uterine Neoplasms/etiologyABSTRACT
OBJECTIVE: Case report of a very rare case of ovarian implantation after IVF and ET treated by laparoscopy. DESIGN: Case report. SETTING: Institute for the Care of Mother and Child, Prenatal Diagnostic Centre and Trophoblastic Disease Centre, Prague, Institute for Postgraduate Medical Education, Prague. RESULTS: We observed implanted product of conception found within the ovarian stroma 35 days after ET. At laparoscopy, the genital sac appeared as an inconspicious haemorrhagic cyst, 2 cm in diameter. After dissection, in the intact sac appeared amorphous 2 mm embryo and 3 mm yolk sac. The trophoblast of the anchoring chorionic villi exhibited marked hyperproliferation and was classified as a proliferating mole. CONCLUSION: The intact early product of conception exhibited trophoblastic hyperplasia.
Subject(s)
Embryo Transfer/adverse effects , Fertilization in Vitro/adverse effects , Hydatidiform Mole, Invasive/pathology , Ovarian Neoplasms/pathology , Pregnancy, Ectopic/etiology , Adult , Female , Humans , Hydatidiform Mole, Invasive/etiology , Ovarian Neoplasms/etiology , Ovary , Pregnancy , Pregnancy, Ectopic/pathology , Trophoblasts/pathologyABSTRACT
A combination of estrogen and levonorgestrel was continuously delivered to 23 adult rabbits for up to 2 years via a Silastic ring device sutured into the vagina. Twenty-one control rabbits were given similar rings devoid of drugs. A marked decidual reaction of the endometrium occurred in 16 of 23 test rabbits. In 14 test rabbits (61%) malignant tumors developed of decidual type cells not heretofore described. The deciduosarcomas were composed of anaplastic cells that invaded the uterine walls, uterine lymphatics, and in 4 of 13 (31%) rabbits that survived 2 years of treatment, the tumors metastasized to the lungs. Several deciduosarcomas appeared to arise within the spleen or other abdominal organs. Other drug-related lesions included uterine or vaginal polyps, endometrial atrophy, and focal necrosis and mineralization of the uterine wall. Cells from several deciduosarcomas failed to produce tumors in nude mice or to colonize on soft agar. No decidualization or decidual neoplasms were seen in the controls.
Subject(s)
Contraceptive Agents, Female/toxicity , Estradiol/toxicity , Hydatidiform Mole, Invasive/pathology , Norgestrel/toxicity , Uterine Neoplasms/pathology , Animals , Contraceptive Agents, Female/administration & dosage , Decidua , Drug Combinations , Drug Implants , Endometrium/ultrastructure , Estradiol/administration & dosage , Female , Hydatidiform Mole, Invasive/etiology , Levonorgestrel , Male , Mice , Mice, Nude , Microscopy, Electron , Norgestrel/administration & dosage , Ovary/pathology , Polyps/pathology , Pregnancy , Rabbits , Silicone Elastomers , Spleen/pathology , Uterine Neoplasms/etiology , Uterus/pathologySubject(s)
Choriocarcinoma/etiology , Hydatidiform Mole, Invasive/etiology , Hydatidiform Mole , Neoplasms, Multiple Primary , Uterine Neoplasms , Adult , Age Factors , Female , Humans , Middle Aged , Parity , Pregnancy , Prognosis , RiskABSTRACT
A case-control study to determine the gynecologic and reproductive risk factors for gestational trophoblastic neoplasia was conducted in the Baltimore Metropolitan Area. All cases (N = 190) that were pathologically diagnosed from 1975 to 1982 as hydatidiform mole, invasive mole, or choriocarcinoma were ascertained. Slides were independently reviewed by two pathologists. Cases were matched by age, race, and last menstrual period to controls who were delivered of normal pregnancies at term. In the analysis of medical record and interview data, factors found to be positively associated with gestational trophoblastic neoplasia included professional occupations (odds ratio = 2.56, p less than 0.0001), prior spontaneous abortions (odds ratio = 2.32, p = 0.02), and the mean number of months from the last pregnancy to the index pregnancy (cases = 35.9, controls = 28.2; p = 0.03). Factors found not to be associated with disease included contraceptive history, irradiation, ABO blood group, and smoking factors of the male partner. The findings suggest that gestational trophoblastic neoplasia may be part of a continuum of early (first-trimester) reproductive abnormalities.
