Gestational trophoblastic disease

Intermediate_trophoblast_3_-_low_mag.jpg

Gestational trophoblastic disease (GTD) is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus. These tumors start in the cells that would normally develop into the placenta during pregnancy. GTD is a spectrum of diseases that includes hydatidiform mole, invasive mole, choriocarcinoma, and placental-site trophoblastic tumor.

Types of Gestational Trophoblastic Disease

GTD encompasses several different conditions, each with unique characteristics:

• Hydatidiform mole: Also known as a molar pregnancy, this condition occurs when the tissue that normally becomes a fetus instead forms an abnormal growth in the uterus. There are two types: complete and partial moles.
• Invasive mole: This type of mole penetrates the muscle layer of the uterus and can cause significant bleeding.
• Choriocarcinoma: A fast-growing cancer that can spread to other parts of the body, including the lungs, liver, and brain.
• Placental-site trophoblastic tumor: A rare form of GTD that arises from the placental implantation site and can invade the muscle layer of the uterus.

Symptoms

The symptoms of GTD can vary depending on the type and stage of the disease. Common symptoms include:

• Abnormal vaginal bleeding
• Excessive nausea and vomiting
• High blood pressure with protein in the urine (preeclampsia)
• Rapidly enlarging uterus
• Elevated levels of human chorionic gonadotropin (hCG)

Diagnosis

Diagnosis of GTD typically involves a combination of:

• Pelvic examination
• Ultrasound
• Measurement of hCG levels
• Histopathological examination of tissue samples

Treatment

Treatment options for GTD depend on the type and extent of the disease. They may include:

• Dilation and curettage (D&C) to remove molar tissue
• Chemotherapy for malignant forms like choriocarcinoma
• Hysterectomy in severe cases or for placental-site trophoblastic tumors

Prognosis

The prognosis for GTD is generally good, especially when diagnosed early. Most cases of hydatidiform mole are benign and can be treated successfully. Malignant forms like choriocarcinoma also have high cure rates with appropriate treatment.

Follow-Up

Patients with GTD require careful follow-up to monitor hCG levels and ensure that the disease has not recurred. Regular follow-up visits typically include:

• Blood tests to measure hCG levels
• Physical examinations
• Imaging studies if necessary

See Also

• Pregnancy
• Placenta
• Cancer
• Oncology

External Links

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