The source of estradiol-17beta in trophoblastic neoplasia

Unconjugated and conjugated estradiol-17beta (E2) were measured in the sera of four patients with hydatidiform mole at frequent intervals after removal of the mole, in the left and right ovarian vein blood in a patient with hydatidiform mole, in the peripheral sera and serous fluid of the molar vesicles in seven cases of hydatidiform mole, and in the fluid from the left and right theca lutein cyst (TLC) of a molar pregnancy, by a radioimmunoassay method. Patients with highly elevated serum E2 had a rapid clearance of E2 within 24 to 36 hours after removal of the mole; those with minimal E2 elevation had a slower clearance of the hormone from the circulation. Mole vesicle fluid had undetectable E2 but a wide range of unconjugated E2 which was usually lower than in the peripheral blood. Both ovarian vein blood and TLC fluid have higher E2 concentrations than the peripheral blood. The significance of these findings is discussed in relation to the contribution of the trophoblast and the ovaries to the circulating E2.