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:: Volume 3, Issue 3 (September 2018) ::
jogcr 2018, 3(3): 123-128 Back to browse issues page
New Management of Gestational trophoblastic diseases; A Continuum of Moles to Choriocarcinoma: A Review Article
Soheila Aminimoghaddam * , Nastaran Abolghasem , Tahereh Ashraf- Ganjooie 1
1- Obstetrics & Gynecology Department, Medical Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:   (72 Views)
Introduction Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.
Keywords: Gestational trophoblastic neoplasia, Hydatidiform mole, Chemotherapy, Pregnancy
Full-Text [PDF 459 kb]   (20 Downloads)    
Systematic Review: Review | Subject: General
Received: 2018/03/13 | Accepted: 2018/04/29 | Published: 2018/09/22
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Aminimoghaddam S, Abolghasem N, Ashraf- Ganjooie T. New Management of Gestational trophoblastic diseases; A Continuum of Moles to Choriocarcinoma: A Review Article. jogcr. 2018; 3 (3) :123-128
URL: http://jogcr.com/article-1-211-en.html


Volume 3, Issue 3 (September 2018) Back to browse issues page
Journal of Obstetrics, Gynecology and Cancer Research (JOGCR)
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