Gestational Trophoblastic Disease Flashcards
What is gestational trophoblastic disease?
Term used to describe a group of pregnancy-related tumours
Give examples of premalignant gestational trophoblastic disease
Complete/partial molar pregnancy
Give examples of malignant gestational trophoblastic disease
Invasive mole
Choriocarcinoma
Placental trophoblastic site tumour
Epithelioid trophoblastic tumour
What is a partial molar pregnancy?
When one ovum is fertilised by two sperms - results in triploidy
When is a complete molar pregnancy?
When one ovum with no chromosomes is fertilised by either
one sperm which duplicates
or
two sperm
What is a choriocarcinoma?
Malignancy of trophoblastic cells of the placenta
Where does choriocarcinoma tend to metastasise?
Lungs
Which tumour does an epithelial trophoblastic tumour mimic?
SCC
What are the major risk factors for gestational trophoblastic disease?
<20, >35
Prev disease
Prev miscarriage
OCP
How do molar pregnancies tend to present?
Bleeding and abdo pain in early pregnancy
Uterus larger than expected
Soft, boggy uterus
What does an undiagnosed molar pregnancy go on to cause?
Hyperemesis
Hyperthyroidism
Anaemia
Why does hyperemesis occur with molar pregnancy?
Increased beta-hCG
Why does hyperthyroidism occur in molar pregnancy?
High hCG levels stimulate thyroid
How is gestational trophoblastic disease investigated?
beta-hCG levels
USS
Histology of products of conception
How is molar pregnancy managed?
Suction curettage if early
Medical evac if later
