GTN Flashcards
Placental site trophoblastic tumors most commonly develop following which type of pregnancy?
Term gestation
Most likely genetic for a partial mole?
69, XXX
69, XXY
(1 egg, 2 sperm)
HAS FETAL PARTS
Risk of GTN after partial mole?
< 5%
Positive p57 Kip2 immunostaining?
Partial Mole
This is a nuclear protein whose gene is paternally imprinted and maternally expressed (because complete moles contain only paternal genes, this protein is absent in complete moles)
Which type of mole is completely paternal DNA?
Complete mole
90% are 46, XX
“Daddy’s girl”
Either one sperm fertilizes an empty egg and then duplicates (most common) OR two sperm fertilize an empty ovum. (could potentially get 46 XY in this case)
Risk of GTN w/ complete mole?
15-20%
No fetal tissue
Enlarged, Edematous Villi
Diffuse trophoblastic proliferation
Complete Mole
Scalloping of chorionic villi
Focal/various villious edema
Fetal parts present
Incomplete Mole
Theca Lutein cysts are associated with which type of mole?
Complete Mole
Tx for molar pregnancy
US guided D&C
Pre Op: Quant
T&S, CBC
LFTs
Cr
TFT
Coags
CXR (to look for mets)
Surveillance after evacuation after a molar pregnancy?
First draw 48h after evacuation
Weekly until Neg x 3
Monthly x 6
Risk factors for development of post molar GTN?
Complete Mole
hcG > 100k
Uterine size > dates
Theca Lutein cysts > 6 cm
Malignant transformation of GTD
- Increased 10% over 2 wks
- Plateu +/- 10% over 3 weeks
- Present after 6 months
- Path pos for invasive mole
- Presence of mets
GTN most common following term pregnancy
Choriocarcinoma
GTN most common following molar pregnancy?
Invasive Mole
