part 2 GESTATIONAL TROPHOBLASTIC DISEASE

GTN (gestational trophoblastic neoplasia)PART 2
Learning objectives:
To clarify the definition, aetiology, risk factors and the classification of GTN
Genetics of H.Mole
Diagnosis of GTN
Principles of management of both benign and malignant varieties

CLASSIFICATION:
1- Benign (hydatidiform mole) which
further subdivided into partial and
complete mole.
2- malignant:
A- Invasive mole (chorioadenoma
destruens) which can metastasize.
B- Choriocarcinoma (frankly malignant).
C- Placental site trophoblastic tumour
(PSTT).
Malignant GTN
The malignant GTN can be classified into:
the non-metastatic: invasive mole
and the metastatic: choriocarcinoma
and the PSTT
Malignant disease can be suspected when
1- Plateauing or rising B-hCG value over a period of 3 consecutive weeks.
2- A rise of B-hCG over a period of 2 weeks.
3- Persistence of a detectable B-hCG after 6 months of evacuation
Choriocarcinoma:
The incidence:
between 1:10 000 to 1:70 000 deliveries in the west.
And between 1:250 to 1:6000 deliveries in Asia
Choriocarcinoma
The antecedent pregnancy is
1- H. mole in 50%,
2- normal pregnancy in 25%
3- abortion or ectopic pregnancy in 25%.