Gestational Trophoblastic Neoplasm (GTN) Witrak Flashcards
What are the two broad categories of GTNs?
Hydatidiform mole (complete or partial) Persistent (malignant)
What causes a mole?
Aberrant fertilization event
What causes the formation of a complete mole?
Fertilization of an empty ovum by sperm (2 or 1 that duplicates)
What is a complete mole?
Diploid; 46 XX or XY
What causes the formation of a partial mole?
Fertilization of an ordinary ovum by 2 sperm
What is a partial mole?
Triploid; 69 XXX, XXY, or XYY
What are the results of mole formation?
Most are evacuated w/o sequelae
10% persist/become invasive
2% risk of choriocarcinoma
Rare evolution to Placental Site Trophoblastic Tumor (PSTT)
When can choriocarcinoma present?
Months to > 1yr post gestation
What can choriocarcinoma arise from?
Any type of gestation
What are risk factors for GTNs?
Extremes of maternal age
Previous GTN
What symptoms could be seen with GTNs?
Vaginal bleeding Large uterus for dates Pelvic pressure Hyperemesis gravidarum Hyperthyroidism Preeclampsia ocurring < 20wks
What addition symptoms would be seen with a choriocarcinoma?
Metastatic symptoms (lung, CNS)
There is diffuse vesicular enlargement of villi (gross vesicles) with NO fetal sac/fetus. What kind of mole is this?
Complete mole
There is variable vesicular enlargement of villi (gross vesicles) WITH fetal sac/fetus. What kind of mole is this?
Partial mole
What is a choriocarcinoma?
Hemorrhagic/necrotic tumor with mixtures of syncytiotrophoblastic and cytotrophoblastic cells with NO villus formation
