Gestational Trophoblastic Disease Flashcards

1
Q

types of benign and malignant gestational trophoblastic disease

A

benign : complete and partial hydatidiform moles

malignant : persistent/invasive moles, choriocarcinoma, PSTTs

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2
Q

in what race ar hydatidiform moles MC

A

asian

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3
Q

what are risk factors for developing moles

A

extremities in age
prior GTD
nulliparity
low B carotene/folate/fat diet

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4
Q

complete vs partial moles

etiology

A

complete: empty egg + sperm

partial : egg + 2 sperm

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5
Q

complete vs partial moles

karyotype

A

complete: 46, XX (both paternal)

partial : 69, XXY

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6
Q

complete vs partial moles

b-hCG levels, how long does it take to return to normal levels?

A

complete: very high (>100k); 14 wks to return to nml
partial: normal/slightly elevated; 8 wks to return to nml

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7
Q

complete vs partial moles

pathology

A

complete: enlarged uterus + grape cluster villi +/- bilateral theca-lutein cysts
partial: normal sized uterus, fetal parts found on autopsy of abortion products

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8
Q

complete vs partial moles

presentation

A

complete: abnormal vaginal bleeding; severe hyperemesis gravidarum, 1st trimester preeclampsia, hyperthyroid, anemia
partial: missed abortion

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9
Q

complete vs partial moles

malignant potential

A

complete: 15-20% overall, 2% choriocarcinoma
partial: <5% overall, no risk of choriocarcinoma

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10
Q

complete vs partial moles

findings on pelvic US

A

complete: “snowstorm” pattern
partial: “swiss cheese” uterus

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11
Q

complete vs partial moles

management

A

complete: D&C + oxytocin, f/uwith serial b-hCG and relable contraception for next 6 mos
partial: same as complete

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12
Q

low vs high risk malignant GTD

duration
b-hCG levels

A

low: < 4 mos, 4 mos, > 40k, failed chemo, GTD following pregnancy

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13
Q

persistent/invasive moles vs choriocarcinoma vs PSTTs

etiology

A

persistent/invasive moles: remnant of benign hydatiform moles

choriocarcinoma: malignant necrotizing tumor

PSTTs : rare tumors that arise from placental invasion site, have no villi

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14
Q

persistent/invasive moles vs choriocarcinoma vs PSTTs

presentation

A

persistent/invasive moles: presents as plateuign or inc b-hCG s/p molar evacuation

choriocarcinoma: smx of mets (lungs, vagina, liver, brain, kidneys)

PSTTs : abnl vaginal bleeding

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15
Q

persistent/invasive moles vs choriocarcinoma vs PSTTs\

management

A

persistent/invasive moles: single agent chmo for non-met or low risk and multi-agent chemo for high risk

choriocarcinoma: same as persistent/invasive

PSTTs : low b-hCG (persistently <100); hystorectomy + multi-agent chemo

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