**Author details**

(e.g., **Figure 8**). The "snow storm" or "bunch of grapes" appearance is no longer seen with nowadays equipment. In complete moles the embryo is absent, and no amniotic fluid is present [70]. In the first trimester, the diagnosis of complete mole can be difficult; bilateral theca lutein cyst may be seen [71]. In partial mole, the molar placenta may not always be seen; the amniotic cavity is either empty or contains a well-formed but growth-retarded fetus, either dead or alive, with hydropic degeneration of fetal parts [72]. Occasionally, the differential diagnosis between partial moles, complete moles, and missed abortion [73] may be difficult. In molar pregnancy the first step after the diagnosis is the chest X-ray to determine metastasis. Computer tomography and magnetic resonance imaging can add valuable additional information for the final diagnosis. After careful counseling of the patient, including genetic testing, the best treatment option remains suction and curettage for evacuation. Hysterectomy, however, is an option if preservation of the fertility is not necessary. When hCG levels remain elevated after a proper evacuation of the uterine cavity, a gynecology oncology consultation is required to guide the therapy and consider

Choriocarcinoma is a rare aggressive tumor, with highly malignant potential and widespread dissemination metastases [74]. It is considered part of the spectrum of gestational trophoblastic disease and is called *gestational* choriocarcinoma. The high mortality is due to lack of early diagnosis and appropriate chemotherapy [75]. Approximately 5% of cases of complete HM can be complicated with choriocarcinoma. Only about half the cases of choriocarcinoma arise from a complete HM. The imaging diagnosis of choriocarcinoma includes a discrete, central, infiltrative mass enlarging the uterus, with a possible invasion of the myometrium and beyond (e.g., **Figures 9** and **10**). The ovaries may be enlarged, due to cysts secondary to increased levels of hCG [76]. If choriocarcinoma arises from a complete HM, the prognosis is usually favorable after proper chemotherapy. On the contrary, other cases of choriocarcinoma

chemotherapy [68].

**12.2. Choriocarcinoma**

**Figure 8.** Ultrasound image of the case of hydatidiform mole.

338 Congenital Anomalies - From the Embryo to the Neonate

have a less favorable prognosis.

Roxana Cristina Drăgușin<sup>1</sup> \*, Maria Șorop-Florea<sup>1</sup> , Ciprian Laurențiu Pătru<sup>1</sup> , Lucian Zorilă<sup>1</sup> , Cristian Marinaș2 , Bogdan Virgiliu Șorop<sup>3</sup> , Răzvan Căpitănescu<sup>1</sup> and Dominic Gabriel Iliescu1

\*Address all correspondence to: roxy\_dimieru@yahoo.com

1 Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy, Craiova, Romania

2 Department of Anatomy, University of Medicine and Pharmacy, Craiova, Romania

3 Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy, Timișoara, Romania
