GTD Flashcards
Invasive mole
Invasive mole develops after a molar pregnancy and is characterized by the presence of edematous chorionic villi with trophoblastic proliferation invading the myometrium
Frequency of post molar GTN
approximately 15 to 20 percent of patients following complete hydatidiform mole
1 to 4 percent of patients following partial hydatidiform mole
Gestational trophoblastic disease (GTD)
-Lesions characterized by abnormal proliferation of trophoblast of the placenta. This category is comprised of benign, nonneoplastic lesions, including placental site nodule (both typical and atypical), exaggerated placental site, and hydatidiform mole
Gestational trophoblastic neoplasia (GTN)
Gestational neoplasms include: choriocarcinoma, placental site trophoblastic tumor (PSTT), epithelioid trophoblastic tumor (ETT), and invasive mole
disease diagnosed as a result of persistent elevation of human chorionic gonadotropin (hCG) after evacuation of a molar pregnancy is termed GTN
Risk factors for GTD
Prior molar pregnancy
advanced maternal age (>40 years),
Asian and American Indian ancestry
GTN after a nonmolar pregnancy
usually choriocarcinoma but rarely PSTT or ETT
approximately 2 to 7 per 100,000 pregnancies in Europe and North America
Southeast Asia and Japan, the incidence is higher at 5 to 200 per 100,000 pregnancies
. Invasive mole
Invasive mole develops after a molar pregnancy and is characterized by the presence of edematous chorionic villi with trophoblastic proliferation invading the myometrium
complete mole, postmolar GTN high-risk features
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●Pre-evacuation uterine size larger than dates
●Human chorionic gonadotropin (hCG) levels >100,000 milli-international units/mL
●Bilateral ovarian enlargement caused by excess hCG stimulation (theca lutein cysts)
●Previous cesarean section
If present 40-50% risk
What is Choriocarcinoma
Choriocarcinoma is the most aggressive histologic type of GTN and is characterized by early vascular invasion and widespread metastases
