330 HYDATIFORM DEGENERATION IN TUBAL AND UTERINE PREGNANCY. 



the hydatids varied in size from a dot to a "bird cherry" (wild? cherry), and the 

 degeneration was universal, although the menstrual age of this specimen was given 

 as only 51 days. It is significant that Wenzel expresses surprise that even excellent 

 handbooks of the day had nothing to say about hydatiform mole in cases of tubal 

 pregnancy, except perhaps to refer to the case of Otto. Nor does the case of Wenzel 

 seem to be the first one observed or that of Otto the first one reported, for Storch 

 (1878), in truly epochal, though largely ignored, observations on hydatiform mole, 

 cites Hennig (1876) as stating that two cases of moles in the tube were reported by 

 Blasius (very likely E. Blasius, 1802-75). Since Storch wrote on hydatiform mole 

 it is implied that Blasius saw one of these and not one of another type of mole, and 

 since hydatiform mole is such a striking condition and has evoked much more 

 interest than the other forms, an observation regarding it in the tubes well might 

 travel down the decades, particularly since until recently the occurrence of hydati- 

 form degeneration in the tubes was regarded as extremely rare. This is indicated 

 also by the fact that Menu (1899) still referred to the case of Otto as a curiosity. 



Pazzi (1908 :i ) states that two cases of extrauterine moles have been described 

 each by Hennig (1872), Farell (1893), Donald (1902), and one case each by Otto, 

 Freund, Theileher, Maret, Matwjew (Matwejew?) and Sycow (Sykow?), Bland 

 Sutton, and one case of ovarian mole by Wenzel (1893). Wilkinson is said to have 

 described a case of rupture of the tube with reduction of the mole to the size of a 

 cherry, and Lob (1902) also gives a case of molar tubal pregnancy without cessation 

 of menstruation. Since I am quoting Pazzi essentially verbatim, it is evident that 

 he did not read the literature critically or discriminate between ordinary and hydati- 

 form moles, but was misled by the old inclusive and confusing usage of the terms 

 mole and molar, still current at the present day. 



Krueger (1909) also reported a case of hydatiform mole with a cyst as large as 

 a "walnut." The pedicle was 4 cm. long and attached to the amnion near the 

 insertion of the cord. Krueger spoke of this as a placental cyst but regarded it as a 

 hydatiform-mole-like structure which, microscopically, was limited to a single 

 villus. If this were the only evidence presented by Krueger one might well question 

 the nature of the cyst, but he added that microscopically the beginnings of hydati- 

 form formations could be recognized on other villi also. Hence it would seem that 

 Krueger's case must be added to the authenticated cases of hydatiform degenera- 

 tion in the tubes. 



So far as I am able to learn, then, the literature contains reports of 9 cases of 

 hydatiform mole occurring in the tube, but two or three of these cases are not well 

 authenticated. These 9 cases are formed by the 2 cases of Blasius or Hennig, that 

 of Otto, of von Recklinghausen and Freund, and of Wenzel, the 2 of Groom, that 

 of Matwejew and Sykow, and that of Krueger. A critical reading of Hennig's 

 book on diseases of the tubes and tubal pregnancy makes it quite clear, however, 

 itui, Hennig merely said that Blasius discovered "tubal moles" and that he observed 

 two, and Behm one case of abortion of tubal moles. From the context also it is 

 very clear that Hennig was not discussing hydatiform moles, although it is not 



