• A hydatidiform mole is essentially an abnormal embryo that contains many fluid-filled cysts. There are two types of hydatidiform moles, complete and incomplete (partial). The diagnosis of a complete hydatidiform mole is usually made during the first half of a pregnancy and is recognized by the health care provider about 50 percent of the time before the tumor cysts are expelled. A variety of clinical conditions may be confused with molar pregnancy, but these can usually be distinguished on the basis of medical history, a physical exam and an ultrasound examination. In contrast to a complete mole, a partial mole is associated with a fetus. It occurs much less frequently than a complete mole. The fetus usually dies within nine weeks after the last menstrual period although occasionally it can survive to term. Partial moles are rarely associated with multiple ovarian cysts (thecolutein cysts), high HCG titers and other accompaniments of a complete mole. There is also a lower incidence of malignant behavior (5 to 10 percent). • An invasive mole (chorioadenoma destruens) is defined as a hydatidiform mole that invades the wall of the uterine muscle. It develops in 15 to 30 percent of all molar pregnancies. • Choriocarcinoma is a very rapidly growing malignancy that tends to spread quickly. About 50 percent of all cases of gestational choriocarcinoma follow a hydatidiform mole, 25 percent follow a spontaneous abortion or tubal pregnancy and 25 percent follow a normal pregnancy. Choriocarcinoma follows a normal-term pregnancy in 1 in 40,000 pregnancies. GTD after a normal pregnancy is always a choriocarcinoma, never a mole or an invasive mole.