These are little-known female tumors, all the more cruel because they arise while waiting for a “happy event.” In fact, in almost one in a thousand pregnant women in the West (and almost one in a hundred in Asia), a tumor develops from the placenta, this essential organ that ensures the exchange between the mother’s blood and that of the embryo.
During these pathological pregnancies, precancerous lesions called “hydatidiform moles” develop from a layer of cells, the trophoblast, which normally surrounds the embryo and forms numerous villi that anchor the placenta in the uterus.
These moles are the result of a fertilization anomaly, always linked to an excess of chromosomal material of paternal origin, which leads to an absence of an embryo or to a non-viable embryo. Thus, when one or two spermatozoa fertilize an egg without a nucleus, no embryo is formed but a mole proliferates. And when two spermatozoa (or one abnormal spermatozoa) fertilize a normal egg, an embryo begins to develop, but it cannot survive for long.
Miscarriage
Even if there is no embryo, the pregnancy test is positive because the placenta produces large amounts of the “pregnancy hormone” or human chorionic gonadotropin (hCG). Most often, these moles are detected during the ultrasound in the first or second month. “ Then it is necessary to perform uterine evacuation by aspiration. [curetage] »explains Professor Pierre-Adrien Bolze, a gynaecological surgeon at the Lyon-Sud hospital (Hospices Civils de Lyon), which houses the National Reference Centre for Trophoblastic Diseases.
These moles sometimes cause spontaneous abortions, but often do not expel the entire tumor. The woman then experiences persistent bleeding, which prompts her to seek medical attention. After ultrasound and aspiration, the diagnosis is confirmed by histological analysis of the evacuated tissue.
In almost nine out of ten cases, there is no recurrence. However, this must be ensured by measuring the hCG level for six months; if it does not increase, no tumor has developed again. However, in 10% to 15% of cases, the mole develops into a “gestational trophoblastic tumor,” from precancerous cells that persist in the uterus. This concerns about 130 women a year in France, out of between 950 and 1,000 women who develop a hydatidiform mole each year.
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