Complete hydatidiform mole and coexistent fetus (CMCF) is a rare occurrence
and is associated with an increased risk of persistent gestational trophob
lastic diseases. The aim of this study was to reveal a potential risk, fact
or and to determine optimum management of CZ;ICF cases. Molar tissues are c
! cytogenetically divided into two types, homozygous and heterozygous. The
molar tissue of our case showed a 46, XY heterozygous complete mole. Genomi
c DNA was analyzed by the polymerase chain reaction using sers of unlabelle
d forward and Cy-5-labelled reverse primers for DNA marker loci. Tl;e patie
nt developed persistent trophoblastic disease (PTD) with lung metastasis. S
ince 1980 there have been 13 reports (including our case) that cytogenetica
lly revealed CMCF and clarified the clinical outcome. Wine of the 16 CMCF c
ases before 21 weeks of gestation and seven of the 12 CR:LCF cases after 22
weeks of gestation developed PTD. The incidence of PTD from CMCF was not r
elated to the gestational age at termination or delivery. There were 10 cas
e reports that analyzed the zygosity of a mole heterozygous or homozygous.
Two of six homozygous and three of font heterozygous moles in CMCF cases de
veloped PTD. A heterozygous mole is thought to be a high risk factor. for t
he incidence of PTD. Cytogenetic study is clinically useful for the optimum
management of CMCF cases. (C) 2001 Harcourt Publishers Ltd.