scholarly journals Correlation of ultrasound imaging with histopathological findings in gestational trophoblastic disease

2020 ◽  
Vol 7 (3) ◽  
pp. 41-46
Author(s):  
Pooja Jaiswal ◽  
Shreejana Shrestha ◽  
Yogita Dwa ◽  
Sagun Manandhar

Introduction: Gestational trophoblastic diseases include a spectrum of pregnancy-related diseases caused by abnormal proliferation of the placenta.  The main aim of this study was to correlate ultrasound imaging with histopathological findings. Method: This is the retrospective chart review of findings of transabdominal ultrasonography in clinically suspected gestational trophoblastic diseases which were confirmed by histopathology after the evacuation of a product of conception during 3 years from 2016 to 2019 at Patan Hospital, Patan Academy of Health Sciences Nepal. The accuracy of sonography was correlated with histopathological findings and analyzed by Fisher’s Exact or Pearson’s Chi-square tests. The study was approved ethically. Result:  Among 155 clinically suspected gestational trophoblastic diseases, ultrasonography was accurate in 141(91.0%) and confirmed by histopathology; 14(9.0%) were non-molar miscarriages. In 141 histologically confirmed trophoblastic disease, 110(71.0 %) were partial mole, 15(9.7%) complete mole, 12(7.7%) invasive mole and 3(1.9 %) persistent mole, and 1(0.6%) choriocarcinoma. Snowstorm appearance and absence of fetus were statistically significant ultrasonography findings. Conclusion:  The ultrasound is a reliable non-invasive first-line imaging modality for the diagnosis of gestational trophoblastic diseases and had an accuracy of 91% as confirmed by histopathology in this study.

Author(s):  
Wayne Tie ◽  
Kathrene Tajnert

ABSTRACT Gestational trophoblastic diseases (GTD) comprise several entities which all arise due to abnormal growth of trophoblastic cells of the placenta. These disease processes range from benign to malignant. GTD are classified as complete hydatidiform mole, partial mole, invasive mole and choriocarcinoma. The imaging of choice for detecting trophoblastic disease is B-mode ultrasonography and color Doppler. When ultrasonography corresponds with the classic clinical presentation, accurate diagnosis is possible in a majority of cases of GTD. This article goes through several cases of GTD. Each case will demonstrate and review the principles of ultrasound diagnosis of different forms of GTD and apply it to the presented case studies. With early and accurate diagnosis with the help of ultrasonography, the cure rate for GTD is high. How to cite this article Tie W, Tajnert K, Plavsic SK. Ultrasound Imaging of Gestational Trophoblastic Disease. Donald School J Ultrasound Obstet Gynecol 2013;7(1):105-112.


2011 ◽  
Vol 64 (11-12) ◽  
pp. 579-582 ◽  
Author(s):  
Biljana Lazovic ◽  
Vera Milenkovic ◽  
Ljiljana Mirkovic

Introduction. Gestational trophoblastic disease is a heterogenous group of diseases with malignant potential. The aim of this retrospective study was to evaluate potential risk factors in pathogenesis of gestational trophoblastic disease, its morbidity and mortality as well as treatment results. Method. We investigated 82 patients who were treated at the University Clinic of Gynecology and Obstetrics Clinical Center of Serbia from Jan 1st 2000 to Dec 31st 2007. The data were collected from their hospital charts and referred to gynecological anamnesis, diagnosis, protocols of operated patients, diagnosis, histopathological findings, decisions of expert team for trophoblastic disease and hospital discharge. Results. The incidence was 1.5 per 1000 deliveries. The most frequent finding was hydatiform mole (59.8%). The patients were treated by chemotherapy and surgery. All patients survived. Conclusion. The maternal age and a larger number deliveries and abortions are risk factors for gestational trophoblastic disease. The incidence in our clinic is approximately equal to the incidence in western countries in this period.


2021 ◽  
Vol 10 (16) ◽  
pp. 1106-1113
Author(s):  
Akshat Kuchhal ◽  
Harneet Narula ◽  
Amit Jain ◽  
Shivangi Jain

BACKGROUND Gestational trophoblastic diseases have varying clinical presentations with certain diagnostic signs and symptoms. A strong correlation between gestational trophoblastic diseases (GTD) and a previous history of dilation & evacuation (D & E) has been documented in the limited available literature. We wanted to study the spectrum of gestational trophoblastic disease secondary to dilation & evacuation. METHODS A two-year study including all the females who were admitted to MMIMSR Hospital in view of suspicion of gestational trophoblastic disease was conducted with all having a common history of dilatation and evacuation in the recent past. RESULTS Through the analysis we saw the spectrum of GTD including partial mole, complete mole, invasive mole and choriocarcinoma, as well as its complications in the form of arterio-venous malformation (AVM). CONCLUSIONS The two-year experience suggests that dilatation and curettage may predispose a female of reproductive age group to develop gestational trophoblastic disease in the future. Hence, a high index of suspicion is necessary for timely diagnosis and intervention. The study further helped us understand the wide spectrum of the disease and its associated complications. KEY WORDS Abortion, AVM, Dilatation and Evacuation, GTD, GTN


2019 ◽  
Vol 3 (4) ◽  
pp. 409-412
Author(s):  
Carly Blick ◽  
Kraftin Schreyer

In the United States, gestational trophoblastic diseases (GTD), including molar pregnancies, occur in 121 out of 100,000 pregnancies.1 Many patients with GTD may develop hyperthyroidism. GTD-induced thyroid storm is a rare but life-threatening complication of GTD.2 Once patients are hemodynamically stable, the mainstay of definitive treatment is evacuation of the mole.3 We present a case of molar pregnancy-induced thyroid storm presenting as vaginal bleeding, fever, and tachycardia.


2012 ◽  
Vol 19 (02) ◽  
pp. 159-161
Author(s):  
SYED MEHMOOD HASSAN ◽  
SHOAIB NAYYER I HASHM ◽  
BUSHRA AYAZ ◽  
Faisal Rashid Lodhi ◽  
Kanwal Sohail

Objective: The study was carried out to evaluate the frequency and types of gestational. Trophoblastic diseases (GTD) inendometrial curettings received for histopathology examination. Data Source: Pathology Department, Shifa Naval Hospital Karachi. Design ofStudy: It was a Retrospective Descriptive Observational study. Setting: Department of Pathology, Pakistan Naval Ship; Shifa Naval HospitalKarachi. Period: From 2009 till 2010. Material & Methods: A total of 170 cases of endometrial curettage were examined. All specimensreceived with a diagnosis of product of conceptions (POC) or with the clinical suspicion of a gestational trophoblastic disease were included.Results: It was observed that partial mole identified in 57.1 % cases followed by complete mole 21.4%, choriocarcinoma 14.2% and placentalsite Trophoblastic disease 7.1% cases. Nearly half of the cases were diagnosed as having a gestational trophoblastic disease; these were fromthe age groups of 26-30 years followed by 21-25 years. Conclusions: Hydatidiform mole is the commonest gestational trophoblastic disease.Most complete moles are detected clinically but partial moles are misdiagnosed as abortions therefore all cases of abortions should be sent forhistopathological examinations.


Author(s):  
Mamour Gueye ◽  
Mame Diarra Ndiaye Gueye ◽  
Ousmane Thiam ◽  
Youssou Toure ◽  
Mor Cisse ◽  
...  

Choriocarcinoma is a rare neoplasm and a malignant form of gestational trophoblastic disease. Invasive mole may perforate uterus through the myometrium resulting in uterine perforation and intraperitoneal bleeding. But uterine perforation due to choriocarcinoma is rare. We present a case of a young woman who presented 1 year after uterine evacuation of a molar pregnancy with invasive choriocarcinoma complicated by a uterine rupture and haemoperitoneum.


Author(s):  
Ramalingappa C. Antaratani ◽  
Shruthi M.

Background: Gestational trophoblastic disease refers to the heterogeneous group of interrelated lesions that arises from abnormal proliferation of placental trophoblasts. GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Although GTNs commonly follow a molar pregnancy, they can occur after any gestational event, including induced or spontaneous abortion, ectopic pregnancy, or term pregnancy. The study was conducted to know the incidence of different types of gestational trophoblastic diseases in the local population and the percentage of people ultimately requiring chemotherapy.Methods: The retrospective analysis of case record of 124 women with a diagnosis of GTD admitted to Karnataka Institute of Medical Sciences Hubli between November 2008 to November 2017.Results: A total of 124 cases of GTD were reviewed. Hydatidiform mole was diagnosed in 91 patients; of those experienced spontaneous remission after evacuation. 04 patients had persistent gestational trophoblastic Neoplasia and 13 cases of invasive mole (GTN) 1 case of epitheloid trophoblastic tumors and 15 cases of choriocarcinoma 99 (80%) had low-risk GTN, 25 (20%) had high-risk GTN.Conclusions: Hydatidiform mole was found to be the most common form of gestational trophoblastic diseases. Majority of the cases got cured by simple surgical evacuation. During the course of our study some rare cases of gestational trophoblastic diseases were noted. Patients’ compliance for serial follow up is a highly challenging task in developing countries. Registration of women with GTD represents a minimum standard of care.


2012 ◽  
Vol 65 (5-6) ◽  
pp. 244-246 ◽  
Author(s):  
Biljana Lazovic ◽  
Vera Milenkovic ◽  
Spomenka Djordjevic

A retrospective descriptive study about the presence of metastases, epidemiological characteristics and treatment of 104 patients suffering from gestational trophoblastic disease was performed in the period from 1st Jan, 2000 to 31st December, 2010. Of eleven patients who were found to have metastases (10.6%), 72.7% had pulmonary metastases, 27.3 had vaginal, and one patient had both pulmonary and brain metastases. The average age was 33.9. Antecedent molar pregnancy was recorded in 63.6% patients. Invasive mole was more frequent than choriocarcinoma (63.6%). According to the World Health Organization criteria, 7 patients (63.6%) had high risk score (the average World Health Organization score was 8.4). All patients were treated by chemotherapy, the average number of courses being 1.8. Complete remission was achieved in all patients. Treatment of metastatic disease depends on multiple factors. However, combined chemotherapy is the universally accepted treatment. If chemotherapy is individualized and applied on time, the prognosis is good, even in cases with cerebral metastases.


1994 ◽  
Vol 4 (1) ◽  
pp. 36-42 ◽  
Author(s):  
H. Y.S. Ngan ◽  
A. D.B. Lopes ◽  
I. J. Lauder ◽  
B. H. Martin ◽  
L. C. Wong ◽  
...  

A retrospective evaluation of prognostic factors in 55 patients suffering from metastatic gestational trophoblastic disease (MGTD) treated by modified Bagshawe's CHAMOCA regimen was done. The prognostic significance of the eight prognostic factors in the WHO scoring system, number of sites of metastasis and FIGO staging were evaluated by univariate analysis using Chi-square test with Yates' correction and odds ratio and by multivariate analysis using Cox proportional hazard analysis and logistic regression analysis. In the univariate analysis, the intervals between antecedent pregnancy and the diagnosis of GTD, (P= 0.004) the level of hCG (P= 0.02) and the number of metastatic sites (P= 0.046) were significantly associated with death. In the multivariate analysis, only the interval between the antecedent pregnancy and the diagnosis and the level of hCG were significantly associated with death. Thus, it seems that the interval between antecedant pregnancy and the diagnosis and the level of hCG were the two most significant factors in predicting mortality in high risk MGTD. The WHO staging was more predictive of poor outcome than that of the FIGO staging in this group of patients.


Sign in / Sign up

Export Citation Format

Share Document