scholarly journals A review on gestational trophoblastic disease

2016 ◽  
Vol 44 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Shirin Akter Begum ◽  
Md Zillur Rahman Bhuiyan ◽  
Rehana Akhter ◽  
Romena Afroz ◽  
Afroza Khanom ◽  
...  
Keyword(s):  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
The Body ◽  
Molar Pregnancy ◽  
Foetal Tissue ◽  
Placental Site ◽  
Abnormal Cells ◽  
Caucasian Women ◽  
Invasive Mole ◽  
The Uk

Molar pregnancy occurs when the fertilization of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. This condition is one of a group of conditions known as gestational trophoblastic tumours (GTTs). Molar pregnancies used to be called hydatidiform mole but now most people call them molar pregnancies. Molar pregnancies are rare but they are the most common type of gestational trophoblastic tumour. In the UK, about 1 in 590 pregnancies is a molar pregnancy. In Asian women, molar pregnancies are about twice as common as in Caucasian women. Most molar pregnancies are benign. They can spread beyond the womb in some women, but are still curable. Molar pregnancies can either be complete or partial. In case of complete mole, no parts of foetal tissue are formed. In case of partial mole there may be some foetal tissue in the womb, alongside the molar tissue. By measuring the levels of ?hCG in blood and urine in high dilution helps to diagnose a molar pregnancy; an ultrasound scan can also diagnose many women with molar pregnancy. The molar tissue needs to be surgically removed. Afterwards, in around 10 to 15 out of 100 women, some molar tissue remains in the deeper tissues of the womb or other parts of the body. This is called a persistent gestational tumour. Invasive mole, choriocarcinoma, and placental site trophoblastic tumor (PSTT) termed as “gestational trophoblastic neoplasia” (GTN), which can progress, invade, metastasize, and lead to death if left untreated.These women need to have chemotherapy completely get rid of the abnormal cells.Bangladesh Med J. 2015 Jan; 44 (1): 51-56

scholarly journals A rare case of invasive mole following evacuation of molar pregnancy and its management

2016 ◽  
Author(s):  
Krati Gandhi ◽  
Pushpa Dahiya
Keyword(s):  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Mri Findings ◽  
Loss To Follow Up ◽  
Abnormal Growth ◽  
Trophoblastic Disease ◽  
Placental Site ◽  
Β Hcg ◽  
Invasive Mole

Introduction: Gestational trophoblastic disease (GTD) is a spectrum of abnormal growth and proliferation of trophoblasts that continue even beyond the end of pregnancy. It comprises of hydatidiform mole, invasive mole, choriocarcinoma and placental site tumor. Invasive mole (Choreoadenoma destruens) comprises about 5-8% of all GTD. It has invasive and destructive potentialities. Case Report: We report a case of 22 yr old female, G3P0A2, with 3 months amenorrhea with c/o pain abdomen since 4 days with no c/o bleeding p/v, with raised level of β hcg after two spontaneous abortions. On clinical examination vitals were stable. P/A ut 16-18 wks, doughy feel, slight tender. P/V os closed, ut 16-18 wks, bpv+. Ultrasonography shows multicystic lesion in cervix and vagina with loss of fat planes with UB. β hcg level was more than 5,00,000. Suction evacuation was done and products sent for histopathology. MRI Pelvis was also done in which invasive mole was diagnosed. 4 doses of inj. Methotrexte f/b folinic acid was given but β hcg levels did not fall by log 10. On histopath there was no evidence of invasive mole but 2nd line chemotherapy (EMACO) was started on the basis of MRI findings. Patient has received 5 cycles of EMACO REGIME with β hcg level being followed and is on decreasing trend, has reached to 5.90 mIU/ml. Conclusion: Patient of molar pregnancy should be followed regularly for early diagnosis of persistent gestational trophoblastic disease and adequate management as loss to follow up patients may land up into complications.

scholarly journals A Case of Invasive Mole

2017 ◽  
Vol 12 (2) ◽  
pp. 86-87
Author(s):  
Shahana Ahmed ◽  
Dipti Rani Shaha
Keyword(s):  
Hydatidiform Mole ◽  
The Body ◽  
Emergency Laparotomy ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Partial Hydatidiform Mole ◽  
Normal Limits ◽  
History Of ◽  
Invasive Mole

Invasive mole is a condition where a molar pregnancy, such as a partial hydatidiform mole or complete hydatidiform mole, invades the wall of the uterus, potentially spreading and metastasizing to other parts of the body. Here is a case who presented with history of evacuation for molar pregnancy. She presented with irregular P/V bleeding on and off and after admission silent perforation with massive haemoperitoneum was detected for which emergency laparotomy was done. She recovered and was followed up till her b-hCG levels were within normal limits. As patient presented to us with haemoperitoneum and on laparotomy, there was invasion into whole of the uterus, it could not be saved and hysterectomy was done.Faridpur Med. Coll. J. Jul 2017;12(2): 86-87

scholarly journals Gestational Trophoblastic Disease: Review of Cases Managed at B P Koirala Memorial Cancer Hospital

2013 ◽  
Vol 8 (1) ◽  
pp. 18-21
Author(s):  
Jitendra Pariyar ◽  
B Shrestha ◽  
J Shrestha ◽  
J Shrestha ◽  
BP Rauniyar ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Hydatidiform Mole ◽  
Single Agent ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Brain Irradiation ◽  
Trophoblastic Disease ◽  
Cancer Hospital ◽  
Invasive Mole ◽  
Multiagent Chemotherapy

Aims: This study was done to analyze the clinical presentation and management outcomes of gestational trophoblastic disease managed at B.P. Koirala Memorial Cancer Hospital, Chitwan, Nepal. Methods: Descriptive study was conducted at B.P. Koirala Memorial Cancer Hospital. Case records of all gestational trophoblastic cases from January 2001 to December 2007 were analyzed regarding clinical details, investigations and treatment outcomes. Results: Forty-five cases of 16 to 50 years (mean 29.1 years) had gestational trophoblastic disease, among which 19 (43%) were of Tibeto- Burmese and 15 (33%) Indo-Aryan ethnic group. Hydatidiform mole, invasive mole and choriocarcinoma were observed in 17 (37.8%), six (13.3%) and 22 (48.8%) cases respectively. In seven cases (15.5%) molar pregnancy had occurred in primigravida, seven cases (15.5%) had previous molar pregnancy and in 16 (35.5%) cases GTD had occurred following abortion. Vaginal bleeding was the commonest presentation and 26 (57.8%) cases had anaemia. Eleven (24.5%) cases had theca luteal cyst, 17 (37.8%) had lung metastasis and 4 (8.9%) had brain metastasis. Chemotherapy was administered in 34 (75.5%) cases, among which 15 (33.3%) received single agent and 18 (40%) received multiagent chemotherapy. Hysterectomy was done in nine (20%) cases. Brain irradiation was done in a case with brain metastasis. Five (11.2%) cases with high WHO risk score left the hospital against medical advice. There were three (6.6%) mortalities. Thirty-seven (72.1%) cases were in remission and follow-up. Conclusions: Early diagnosis of disease and proper management strongly influences the outcome of GTD. Even in disseminated state GTD can be cured. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 18-21 DOI: http://dx.doi.org/10.3126/njog.v8i1.8855

scholarly journals Recurrent hydatidiform mole transformed into invasive mole with co-morbid depression- a rare case report

2017 ◽  
Vol 6 (7) ◽  
pp. 3197
Author(s):  
Nisha Bhagat ◽  
Rajnish Raj
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Placental Site Trophoblastic Tumor ◽  
Trophoblastic Disease ◽  
Placental Site ◽  
Rare Case Report ◽  
Invasive Mole ◽  
Methotrexate Chemotherapy

The gestational trophoblastic disease is a group of interrelated lesions that arise from abnormal proliferation of placental trophoblast. It comprises of hydatidiform mole (partial or complete), invasive mole, placental site trophoblastic tumor and choriocarcinoma. The occurrence of hydatidiform mole in more than two conceptions is known as recurrent hydatidiform mole. Although, its incidence is less than 2% but it may progress to invasive mole or choriocarcinoma. The case of 26-year old female is reported; she had five consecutive molar pregnancies and the sixth one developed into invasive mole with co-morbid depression that was managed by methotrexate chemotherapy, antidepressant and psychotherapy. 

Malignant disease in pregnancy

2010 ◽  
pp. 2181-2185
Author(s):  
Robin A.F. Crawford
Keyword(s):  
Hydatidiform Mole ◽  
Gestational Trophoblastic Disease ◽  
Molar Pregnancy ◽  
Live Births ◽  
Trophoblastic Disease ◽  
Gestational Choriocarcinoma ◽  
Placental Site ◽  
Cancer In Pregnancy ◽  
Malignant Trophoblast ◽  
In Pregnancy

Cancer in pregnancy is rare, affecting less than 1 in 1000 live births. It may be specific to pregnancy (gestational trophoblastic disease) or incidental to it, the less infrequent conditions being melanoma, lymphoma, and cervical malignancy. Gestational trophoblastic disease—a group of conditions that arise in the fetal chorion during various types of pregnancy: histologically they are categorized as (1) partial or complete hydatidiform mole, (2) gestational choriocarcinoma, or (3) placental site trophoblastic tumour. The most common of these conditions is molar pregnancy, when villi are present in association with malignant trophoblast in gestational choriocarcinoma....

Invasive mole presenting as acute abdomen- a case report

Mediscope ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 38-39
Author(s):  
AJ Peea
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Abdomen ◽  
Acute Abdominal Pain ◽  
Hydatidiform Mole ◽  
Molar Pregnancy ◽  
Total Hysterectomy ◽  
Placental Site ◽  
Invasive Mole ◽  
Tumour Spectrum

Gestational trophoblastic neoplasms include the tumour spectrum of hydatidiform mole (complete and partial), invasive mole, (chorioadenoma destruens), placental site trophoblastic tumour and choriocarcinoma. Here a case is reported as invasive hydatidiform mole presenting as an acute haemoperitoneum. The patient presented with acute abdominal pain and signs of haemoperitoneum. Emergency laparatomy releaved a perforating molar pregnancy, resulting in massive haemoperitoneum. Total hysterectomy was done, 5 units blood were transfused. Serum _HCG levels regress quickly and spontaneously.Mediscope Vol. 4, No. 1: Jan 2017, Page 38-39

scholarly journals Choriocarcinoma with uterine rupture presenting as acute haemoperitoneum and shock

2017 ◽  
Vol 6 (3) ◽  
pp. 1141 ◽  
Author(s):  
Mamour Gueye ◽  
Mame Diarra Ndiaye Gueye ◽  
Ousmane Thiam ◽  
Youssou Toure ◽  
Mor Cisse ◽  
...  
Keyword(s):  
Young Woman ◽  
Uterine Rupture ◽  
Gestational Trophoblastic Disease ◽  
Uterine Perforation ◽  
Molar Pregnancy ◽  
Rare Neoplasm ◽  
Trophoblastic Disease ◽  
Intraperitoneal Bleeding ◽  
Invasive Mole

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.

Gestational trophoblastic neoplasia

2011 ◽  
pp. 1298-1305
Author(s):  
Philip Savage ◽  
Michael J. Seckl
Keyword(s):  
Gestational Trophoblastic Disease ◽  
Gestational Trophoblastic Neoplasia ◽  
Team Working ◽  
Life Saving ◽  
Placental Site ◽  
Additional Chemotherapy ◽  
Invasive Mole ◽  
Cure Rates ◽  
Prompt Diagnosis ◽  
Hydatidiform Moles

Arising from the cells of conception, gestational trophoblastic disease (GTD) forms a spectrum of disorders from the premalignant complete and partial hydatidiform moles through to the malignant invasive mole, choriocarcinoma and very rare placental site trophoblastic tumours (PSTT). The latter three conditions are also collectively known as gestational trophoblastic neoplasia (GTN) and, although uncommon, are important to recognize as this enables life-saving therapy to be commenced. About 10% of molar pregnancies fail to die out after uterine evacuation and transform into malignant GTN that require additional chemotherapy (1). These cases are usually recognized early and therefore rarely prove difficult to treat, with cure rates approaching 100% reported in most modern series (2). However, GTN can also develop after any type of pregnancy including miscarriages, term deliveries, and medical abortions. Such patients are often not suspected of having GTN and may present late with widespread disease associated with a wide variety of medical, surgical, and gynaecological problems (3). The prompt diagnosis and early effective treatment of these women is aided by an awareness and understanding of these rare, but highly curable malignancies and good team-working between physicians, gynaecologists, pathologists, and oncologists

scholarly journals Genetic Screening of Susceptible Women to Recurrent Molar Pregnancy for Prevention of Gestational Choriocarcinomas

2021 ◽  
Author(s):  
Khalil Khashei Varnamkhasti
Keyword(s):  
Hydatidiform Mole ◽  
Gene Mutations ◽  
Clinical Importance ◽  
Recessive Gene ◽  
Middle Layer ◽  
Gestational Trophoblastic Disease ◽  
Compound Heterozygous ◽  
Molar Pregnancy ◽  
Gestational Choriocarcinoma ◽  
Increased Risk

Hydatidiform mole is an abnormal pregnancy characterized by hyper-proliferation of trophoblastic cells (both cytotrophoblast and syncytiotrophoblast). If the proliferation phenomenon not well controlled, e.g. due to poor medical health care system, mole can become invasive and lead to gestational choriocarcinomas. Gestational choriocarcinoma by strong metastatic potentiality, as one of the most aggressive, malignant form of gestational trophoblastic disease, could be spread through directly vascular and the middle layer of the uterine wall (Myometrium‎) and would involve distant sites such as the lungs, spleen, intestines, kidney, and liver. When a hydatidiform mole occurs once, it is known as sporadic hydatidiform mole; if it happens again, the condition is known as recurrent hydatidiform mole. In recurrent form, the gestational choriocarcinoma occurrence risk increased up to a 100-fold. Therefore, early onset identify of susceptible women to recurrent molar pregnancy is clinical importance because of the increased risk of developing neoplasia. Due to the role of maternal homozygous and compound heterozygous recessive gene, mutations have been reported in hydatidiform mole occurrence, women screening can be improved by molecular genotyping methods.

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