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Gestational trophoblastic disease (GTD) is a term used for a group of pregnancy-related tumours. [1] These tumours are rare, and they appear when cells in the womb start to proliferate uncontrollably. The cells that form gestational trophoblastic tumours are called trophoblasts and come from tissue that grows to form the placenta during pregnancy.
Gestational choriocarcinoma is a form of gestational trophoblastic neoplasia, which is a type of gestational trophoblastic disease (GTD), that can occur during pregnancy. It is a rare disease where the trophoblast , a layer of cells surrounding the blastocyst , undergoes abnormal developments, leading to trophoblastic tumors .
Choriocarcinoma is a malignant, trophoblastic [1] cancer, usually of the placenta. It is characterized by early hematogenous spread to the lungs. It belongs to the malignant end of the spectrum in gestational trophoblastic disease (GTD). It is also classified as a germ cell tumor and may arise in the testis or ovary.
Women who have had a prior partial or complete mole have a slightly increased risk of a second hydatidiform mole in a subsequent pregnancy, meaning a future pregnancy will require an earlier ultrasound scan. [21] In 10 to 15% of cases, hydatidiform moles may develop into invasive moles. This condition is named persistent trophoblastic disease (PTD
The exact cause of gestational trophoblastic neoplasia (GTN) is unknown. GTN often arises after molar pregnancies but can also occur after any gestation including miscarriages and term pregnancies. [6] Although risk factors may impact on the development of the tumor, most do not directly cause of disease.
[1] [2] On ultrasound and MRI, theca lutein cysts appear in multiples on ovaries that are enlarged. [3] Theca lutein cysts are associated with gestational trophoblastic disease (molar pregnancy), choriocarcinomas, and multiple gestations. [4] [5] In some cases, these cysts may also be associated with diabetes mellitus and alloimmunisation to Rh-D.
A placental site trophoblastic tumor is a form of gestational trophoblastic disease, which is thought to arise from the intermediate trophoblast. [1] The tumor may secrete human placental lactogen, [2] and result in a false-positive pregnancy test. [3]
Epithelioid trophoblastic tumors (ETTs) are resistant to chemotherapy, but an immunotherapy drug called dostarlimab treats gestational trophoblastic neoplasia. ETT is a form of GTN. Stage I disease is treated with hysterectomy, while metastatic disease is treated with surgery and chemotherapy. [2]