Question

In a case of vesicular mole, all of the following are high risk factors for the development of choriocarcinoma except:

• A. Serum HCG levels > 1,00,000 IU/ml
• B. Uterus size larger than 16 weeks
• C. Features of thyrotoxicosis
• D. Presence of bilateral theca lutein cysts of ovary

Hint:

Recall Hammond's criteria for high risk mole: hCG, uterine size, theca lutein cysts, age. Thyrotoxicosis is a complication, not a defining marker.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
A hydatidiform mole can turn into a persistent trophoblastic tumour or choriocarcinoma after evacuation. Doctors use a set of markers to sort moles into low risk and high risk groups. We need to spot the option that is NOT one of these markers.

Step 2: Key Formula or Approach:
The classic set of high risk markers (often called Hammond's criteria) are: hCG level above $1,00,000$ IU/ml, uterus size well beyond the expected date, theca lutein cysts bigger than $6$ cm (usually bilateral), and maternal age past $40$.

Step 3: Detailed Explanation:
Check each option against this list. hCG $>1,00,000$ IU/ml matches the first marker directly. A uterus larger than $16$ weeks reflects excess trophoblastic bulk and matches the second marker. Bilateral theca lutein cysts match the third marker exactly. Thyrotoxicosis, on the other hand, happens because hCG at very high levels weakly stimulates the thyroid, so it shows up alongside a high risk mole, but it is a downstream complication, not one of the markers used to define the risk group.
This paper's own answer key left this question unmarked in 2002, showing that even then it was seen as debatable, so this answer rests on the standard Hammond framework rather than a printed key.

Step 4: Final Answer:
The finding that is not a defining high risk marker is thyrotoxicosis.
\[ \boxed{\text{Features of thyrotoxicosis}} \]