GESTATIONAL TROPHOBLASTIC DISEASES BY DR NIRANJAN CHAVAN (78)

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07/14/23

Gestational trophoblastic disease (GTD) is a spectrum of both benign and malignant gestational tumors that develop from abnormal proliferation of trophoblast, including hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. These conditions are aggressive with a propensity to widely metastasize. GTN can result in significant morbidity and mortality if left untreated. Early diagnosis of GTD is essential for prompt and successful management while preserving fertility. Initial diagnosis of GTD is based on a multifactorial approach consisting of clinical features, serial quantitative human chorionic gonadotropin (β-hCG) titers, and imaging findings. Treatment involves surgical removal of the molar pregnancy followed by surveillance of serial human chorionic gonadotropin levels to confirm resolution of disease or to identify development of gestational trophoblastic neoplasia (GTN), which includes invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Although GTN is the invasive or metastatic form of GTD, it has an excellent cure rate with chemotherapy.