Early Detection by Ultrasound of Partial Hydatidiform Mole With a Coexistent Live Fetus.

INTRODUCTION: Twin pregnancy with hydatidiform mole and coexistent live fetus is a rare condition with severe maternal and fetal complications such as preeclampsia, vaginal bleeding, persistent gestational trophoblastic tumor, and fetal death. CASE PRESENTATION: We report a case of a twin pregnancy with histopathologically proven hydatidiform mole and a coexistent live fetus in a 30-year-old Indian woman diagnosed by first trimester ultrasound. DISCUSSION: Our case emphasizes the role of ultrasound in diagnosing this condition in early pregnancy. A succinct overview of etiological mechanisms, possible complications, and clinical management is provided. CONCLUSION: Ultrasound is an effective diagnostic tool to diagnose hydatidiform mole with coexistent live fetus. Early diagnosis of this condition is important for risk stratification and facilitates an informed decision by the patient whether to terminate the pregnancy or to continue until full term with close monitoring after delivery.

Sonographic features of invasive ductal breast carcinomas predictive of malignancy grade.

CONTEXT: Assessment of individual sonographic features provides vital clues about the biological behavior of breast masses and can assist in determining histological grade of malignancy and thereby prognosis. AIMS: Assessment of individual sonographic features of biopsy proven invasive ductal breast carcinomas as predictors of malignancy grade. SETTINGS AND DESIGN: A retrospective analysis of sonographic findings of 103 biopsy proven invasive ductal breast carcinomas. MATERIALS AND METHODS: Tumor characteristics on gray-scale ultrasound and color flow were assessed using American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) Atlas Fifth Edition. The sonographic findings of masses were individually correlated with their histopathologic grades. STATISTICAL ANALYSIS USED: Chi square test, ordinal regression, and Goodman and Kruskal tau test. RESULTS: Breast mass showing reversal/lack of diastolic flow has a high probability of belonging to histological high grade tumor (ß 1.566, P 0.0001). The masses with abrupt interface boundary are more likely grade 3 (ß 1.524, P 0.001) in comparison to masses with echogenic halos. The suspicious calcifications present in and outside the mass is a finding associated with histologically high grade tumors. The invasive ductal carcinomas (IDCs) with complex solid and cystic echotexture are more likely to be of high histological grade (ß 1.146, P 0.04) as compared to masses with hypoechoic echotexture. CONCLUSIONS: Certain ultrasound features are associated with tumor grade on histopathology. If the radiologist is cognizant of these sonographic features, ultrasound can be a potent modality for predicting histopathological grade of IDCs of the breast, especially in settings where advanced tests such as receptor and molecular analyses are limited.