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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.
The symptoms of GTN will vary from person to person. People with the same disease may not have all the symptoms listed. [citation needed] Most common presenting symptom is vaginal bleeding, which is associated with mild elevation of serum β hCG (< 2,500 IU/L). Vaginal bleeding may also occur after delivery that continues for longer than normal.
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.
Gestational trophoblastic disease is a pregnancy-associated concept, forming from the villous and extravillous trophoblast cells in the placenta. [8] Choriocarcinoma are trophoblastic tumors that form in the uterus from villous cells. [8]
It falls under the category of gestational trophoblastic diseases. [1] During a molar pregnancy, the uterus contains a growing mass characterized by swollen chorionic villi, resembling clusters of grapes. [2] The occurrence of a molar pregnancy can be attributed to the fertilized egg lacking an original maternal nucleus.
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. They have rarely been associated with chronic kidney disease and hyperthyroidism. [6]
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.