Materiały źródłowe

• #1 Persistent trophoblastic disease and choriocarcinoma | nidirect

  https://www.nidirect.gov.uk/conditions/persistent-trophoblastic-disease-and-choriocarcinoma

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours. They are known as gestational trophoblastic tumours (GTTs). […] This is known as persistent trophoblastic disease. […] Choriocarcinoma is a very rare type of cancer that occurs in around one in 50,000 pregnancies. It can develop if the cells left behind after a pregnancy become cancerous. […] It can happen several months, or even years, after a pregnancy. […] Although choriocarcinoma starts in the womb, it can spread to other parts of the body, most commonly, the lungs.

• #2 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN involves the malignant entities of GTD, including invasive mole, choriocarcinoma, ETT, and PSTT, all of which can metastasize and be fatal if not treated in a timely and effective manner. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] There are 2 forms of choriocarcinoma: gestational and nongestational. The former arises following an HM, normal pregnancy, or, most commonly, spontaneous abortion, while nongestational choriocarcinomas arise from pluripotent germ cells.

• #3 Invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/invasive-mole-choriocarcinoma

  Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD). Invasive mole is also called persistent trophoblastic disease (PTD). […] An invasive mole and choriocarcinoma are cancers that grow from the tissue that forms in the womb during pregnancy. […] The main known risk factor for invasive mole and choriocarcinoma is a previous molar pregnancy.

• #4 Symptoms of invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/invasive-mole-choriocarcinoma/symptoms

  The main known risk factor for invasive mole and choriocarcinoma is a previous molar pregnancy. […] Invasive mole and choriocarcinoma are cancers that grow from the tissue that forms in the womb during pregnancy. […] Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD).

• #5 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN involves the malignant entities of GTD, including invasive mole, choriocarcinoma, ETT, and PSTT, all of which can metastasize and be fatal if not treated in a timely and effective manner. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] There are 2 forms of choriocarcinoma: gestational and nongestational. The former arises following an HM, normal pregnancy, or, most commonly, spontaneous abortion, while nongestational choriocarcinomas arise from pluripotent germ cells.

• #6 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Gestational trophoblastic disease (GTD) can be benign or malignant. Histologically, it is classified into hydatidiform mole, invasive mole (chorioadenoma destruens), choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Those that invade locally or metastasize are collectively known as gestational trophoblastic neoplasia (GTN). Hydatidiform mole is the most common form of GTN. While invasive mole and choriocarcinoma are malignant, a hydatidiform mole can behave in a malignant or benign fashion. […] A hydatidiform mole is considered malignant when the serum hCG levels plateau or rise during the follow-up period and an intervening pregnancy is excluded. This occurs in 15-20% of hydatidiform moles. […] Histologically, choriocarcinomas have no villi, but they have sheets of trophoblasts and hemorrhage. Choriocarcinomas are aneuploid and can be heterozygous depending on the type of pregnancy from which the choriocarcinoma arose. If a hydatidiform mole preceded the choriocarcinoma, the chromosomes are of paternal origin. Maternal and paternal chromosomes are present if a term pregnancy precedes the choriocarcinoma. Of choriocarcinomas, 50% are preceded by a hydatidiform mole, 25% by an abortion, 3% by ectopic pregnancy, and the other 22% by a full-term pregnancy. […] The most frequent sites of metastases of malignant gestational trophoblastic neoplasia are the lungs, lower genital tract, brain, liver, kidney, and gastrointestinal tract.

• #7 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN involves the malignant entities of GTD, including invasive mole, choriocarcinoma, ETT, and PSTT, all of which can metastasize and be fatal if not treated in a timely and effective manner. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] There are 2 forms of choriocarcinoma: gestational and nongestational. The former arises following an HM, normal pregnancy, or, most commonly, spontaneous abortion, while nongestational choriocarcinomas arise from pluripotent germ cells.

• #8 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN involves the malignant entities of GTD, including invasive mole, choriocarcinoma, ETT, and PSTT, all of which can metastasize and be fatal if not treated in a timely and effective manner. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] There are 2 forms of choriocarcinoma: gestational and nongestational. The former arises following an HM, normal pregnancy, or, most commonly, spontaneous abortion, while nongestational choriocarcinomas arise from pluripotent germ cells.

• #9 Gestational trophoblastic disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gestational-trophoblastic-disease/

  Gestational trophoblastic disease (GTD) is a class of neoplastic conditions characterized by abnormal trophoblast-cell growth in the uterus. […] GTD is classified into hydatidiform moles (molar pregnancy), which are subclassified into complete and partial moles, and gestational trophoblastic neoplasia (GTN), which is subclassified into choriocarcinoma, invasive moles, placental site trophoblastic tumors, and epithelioid trophoblastic tumors. […] Choriocarcinoma: a highly malignant GTN characterized by invasive, highly vascular, and anaplastic trophoblastic tissue without villi. […] Etiology: Choriocarcinoma is preceded by: Hydatidiform mole, Spontaneous abortion or ectopic pregnancy, Term or preterm gestation. […] Malignant transformation of cytotrophoblastic and syncytiotrophoblastic tissue.

• #10 Symptoms of invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/invasive-mole-choriocarcinoma/symptoms

  The main known risk factor for invasive mole and choriocarcinoma is a previous molar pregnancy. […] Invasive mole and choriocarcinoma are cancers that grow from the tissue that forms in the womb during pregnancy. […] Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD).

• #11 Invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.nhs.uk/conditions/persistent-trophoblastic-disease-choriocarcinoma/

  Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD). Invasive mole is also called persistent trophoblastic disease (PTD). […] The main known risk factor for invasive mole and choriocarcinoma is a previous molar pregnancy.

• #12 Epidemiology and aetiology of gestational trophoblastic diseases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14602247/

  Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilisation. […] Maternal age and a history of GTD have been established as strong risk factors for hydatidiform mole and choriocarcinoma. […] We review published data on the worldwide distribution of GTD, original data from cancer-registry-based statistics on choriocarcinoma, and major aetiological hypotheses, including parental age, AB0 blood groups, history of GTD, reproductive factors, oral contraceptive use, and other environmental factors.

• #13 Gestational Trophoblastic Disease | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/gestational-trophoblastic-disease.html

  Gestational trophoblastic disease (GTD) is a group of rare tumors that develop from placental tissue. […] While most GTD tumors are benign (noncancerous), some may become malignant (cancerous). […] The only way to prevent GTD is not to become pregnant. […] Choriocarcinoma: This cancerous tumor forms from trophoblast cells and can spread into the muscles of the uterus, nearby blood vessels, and other organs. It can grow and spread more quickly than other GTNs. Sometimes choriocarcinomas develop from tissue left in the uterus after a miscarriage or delivering a healthy baby. […] Some factors can increase a woman’s risk of developing gestational trophoblastic disease. They include: Being pregnant when you are younger than 20 or older than 35, Having had a previous molar pregnancy, Previous miscarriage, Women from Southeast Asia and those with low dietary carotene also have a higher risk of molar pregnancy and GTN.

• #14 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Gestational trophoblastic disease describes a group of rare pregnancy related disorders that span a spectrum of premalignant and malignant conditions. […] Both complete and partial moles have the potential for malignant transformation but the risk of GTN is higher for CHM (15-20%) than for PHM (0.5-1%). […] Choriocarcinoma is the most aggressive form of GTN with a reported incidence of one per 40000 pregnancies in Europe and North America compared with 9.2 per 40000 pregnancies in South East Asia. […] Although most invasive moles originate from a CHM, only 25% of choriocarcinoma and 25% PSTT and ETT derive from a molar pregnancy. […] The risk of developing choriocarcinoma after a molar pregnancy is higher for CHM (23%) than PHM (1%). […] Hence, gestational choriocarcinoma should be considered in all premenopausal women with metastases of an unknown primary.

• #15 Persistent trophoblastic disease and choriocarcinoma – Know Your Doctor

  https://www.knowyourdoctor.com.cy/medical/persistent-trophoblastic-disease-and-choriocarcinoma/

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours known as gestational trophoblastic tumours (GTTs). […] Choriocarcinoma can develop if the cells left behind after a pregnancy become cancerous. This can happen after any pregnancy, but it is more likely after molar pregnancies. […] If you have had a complete molar pregnancy, you have about a 1 in 10 chance of developing either persistent trophoblastic disease or choriocarcinoma. If you have had a partial molar pregnancy, the risk is around 1 in 100. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent, and 98-100% of women who develop a gestational trophoblastic cancer are cured.

• #16 Gestational Trophoblastic Tumors

  https://www.cancernetwork.com/view/gestational-trophoblastic-tumors

  Gestational trophoblastic tumors (GTTs) encompass a spectrum of neoplastic disorders that arise from placental trophoblastic tissue after abnormal fertilization. […] Although the etiology of GTT is not well understood, the occurrence of this tumor has been associated with several factors: extremes of reproductive age (younger than 20 and older than 40 years), prior molar pregnancy, lower socioeconomic class, and particular ABO blood groups. […] A history of a previous hydatidiform mole is an established risk factor for GTT. […] Lower socioeconomic status has been associated with a greater frequency of GTT. […] The relationship of GTT incidence to different geographic regions, cultures, and socioeconomic statuses suggests that diet and nutrition may contribute to the etiology of this disease. […] The ABO blood groups of parents appear to be related to the development of choriocarcinoma.

• #17 Causes – Gestational Trophoblastic Disease | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/cancer/gestational-trophoblastic-disease/causes.html

  The most common types of gestational trophoblastic disease occur when a sperm cell fertilizes an empty egg cell or when two sperm cells fertilize a normal egg cell. Your risk is higher based on your: […] History of molar pregnancy […] Diet: A few studies have found that a low level of beta-carotene in the diet may be linked with a higher risk of molar pregnancy. More research is needed to confirm this connection.

• #18 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Potential risk factors for the development of molar pregnancy include ethnicity, maternal age, and history of a hydatidiform mole. […] The risk of a second molar pregnancy is about 1% and this risk is greater for CHM than PHM. […] Recent evidence suggests that women who have early diagnosis of PHM as their first gestational event are more likely to develop postmolar GTN. […] Studies have postulated a link in some countries between deficiency of carotene (vitamin A precursor) and a higher incidence of CHM.

• #19 Gestational Trophoblastic Disease (GTD): Symptoms, Causes, Diagnosis, Treatment & Prevention

  https://iswarya.com/gestational-trophoblastic-disease-gtd/

  Gestational Trophoblastic Disease (GTD) is a group of rare conditions in which abnormal growth of trophoblastic cells (cells that normally form the placenta during pregnancy) occurs. […] The exact cause of GTD is not entirely understood, but several factors may increase the risk: […] In both complete and partial molar pregnancies, abnormal fertilization plays a central role. […] Women younger than 20 or older than 35 are at higher risk of developing GTD, particularly molar pregnancies. […] Women who have had one molar pregnancy have an increased risk of having another in future pregnancies. […] Certain ethnic groups, particularly Asian and Hispanic women, have a slightly higher risk of developing GTD. […] While not fully understood, some genetic factors may predispose women to developing GTD. Certain genetic abnormalities, such as Turner syndrome, may be associated with an increased risk of molar pregnancy.

• #20 Molar pregnancy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375175

  An egg fertilized atypically causes a molar pregnancy. […] In a complete molar pregnancy, one or two sperm fertilize an egg. The chromosomes from the mother’s egg are missing or don’t work. The father’s chromosomes are copied. There’s none from the mother. […] In a partial or incomplete molar pregnancy, the mother’s chromosomes are present, but the father supplies two sets of chromosomes. The embryo then has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the father’s genes. […] After removing a molar pregnancy, molar tissue might remain and continue to grow. This is called persistent gestational trophoblastic neoplasia (GTN). GTN happens more often in complete molar pregnancies than it does in partial molar pregnancies. […] Rarely, a cancerous form of GTN known as choriocarcinoma develops and spreads to other organs. Choriocarcinoma is usually successfully treated with chemotherapy. A complete molar pregnancy is more likely to have this complication than is a partial molar pregnancy.

• #21 What Is Gestational Trophoblastic Disease?

  https://www.webmd.com/cancer/gestational_trophoblastic_disease

  Gestational trophoblastic disease (GTD), also called malignant gestational trophoblastic disease, is a rare group of diseases that causes tumors to grow in the uterus after an egg has been fertilized. […] The cause for GTD, even after the delivery of a full-term baby, is also not clear. […] Researchers do know that in the case of complete molar pregnancies, the sperm fertilizes the egg and the fathers chromosomes are copied, but the mothers chromosomes are missing or dont work. In partial molar pregnancies, the embryo has too many chromosomes (69 instead of 46) because the fathers chromosomes are doubled there are two sets. And while the mothers chromosomes are present, they dont work. […] You may be more likely to get a GTD if you: Get pregnant when youre younger than 20 or older than 35; Had a molar pregnancy in the past; Have a history of miscarriages.

• #22 Gestational Trophoblastic Diseases | GLOWM

  https://www.glowm.com/section-view/heading/Gestational%20Trophoblastic%20Diseases/item/262

  Gestational trophoblastic disease (GTD) encompasses a spectrum of disease entities that are often classified together. Histologically, these diseases include complete and partial hydatidiform moles, which are not true neoplasms but rather represent pathologic conceptuses. Molar pregnancies may be considered to have a modest malignant potential, since aggressive local proliferation, myometrial invasion, and systemic metastasis can occur as a result of molar pregnancy, and women with molar pregnancies are at increased risk for developing gestational choriocarcinoma. […] Gestational choriocarcinoma and placental site tumors, on the other hand, are true neoplasms. All of these various disease entities are characterized by focal or diffuse proliferation of trophoblast. […] Detailed histopathologic studies coupled with sophisticated cytogenetic techniques have established the presence of two distinct syndromes of molar disease. A complete mole is consistently associated with a totally paternally derived diploid genotype (diandric diploidy), while a partial mole is associated with complete triploidy that incorporates an extra haploid paternal chromosomal complement (diandric triploidy). […] It is important to recognize distinctions between these two molar syndromes, since they are associated with distinct clinical presentations and different risks for the subsequent development of malignant sequelae.

• #23 Gestational trophoblastic disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gestational-trophoblastic-disease/

  The risk of malignant GTN is higher in complete mole than in partial mole. […] Complete mole is the result of paternal disomy. Partial mole is the result of triploidy. […] Etiology: Fertilization of an empty egg that does not carry any chromosomes by a single sperm. […] Fertilization of an egg containing a haploid set of chromosomes with two sperms. […] The risk of progression to an invasive mole depends on the type of initial hydatidiform mole. […] Complete mole: 15-20% risk of subsequent invasive mole. […] Invasive mole: a form of GTD characterized by the malignant transformation of an incomplete or complete mole.

• #24 Molar pregnancy – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/molar-pregnancy/symptoms-causes/syc-20375175

  An egg fertilized atypically causes a molar pregnancy. […] In a complete molar pregnancy, one or two sperm fertilize an egg. The chromosomes from the mother’s egg are missing or don’t work. The father’s chromosomes are copied. There’s none from the mother. […] In a partial or incomplete molar pregnancy, the mother’s chromosomes are present, but the father supplies two sets of chromosomes. The embryo then has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the father’s genes. […] After removing a molar pregnancy, molar tissue might remain and continue to grow. This is called persistent gestational trophoblastic neoplasia (GTN). GTN happens more often in complete molar pregnancies than it does in partial molar pregnancies. […] Rarely, a cancerous form of GTN known as choriocarcinoma develops and spreads to other organs. Choriocarcinoma is usually successfully treated with chemotherapy. A complete molar pregnancy is more likely to have this complication than is a partial molar pregnancy.

• #25 Gestational Trophoblastic Diseases | GLOWM

  https://www.glowm.com/section-view/heading/Gestational%20Trophoblastic%20Diseases/item/262

  Gestational trophoblastic disease (GTD) encompasses a spectrum of disease entities that are often classified together. Histologically, these diseases include complete and partial hydatidiform moles, which are not true neoplasms but rather represent pathologic conceptuses. Molar pregnancies may be considered to have a modest malignant potential, since aggressive local proliferation, myometrial invasion, and systemic metastasis can occur as a result of molar pregnancy, and women with molar pregnancies are at increased risk for developing gestational choriocarcinoma. […] Gestational choriocarcinoma and placental site tumors, on the other hand, are true neoplasms. All of these various disease entities are characterized by focal or diffuse proliferation of trophoblast. […] Detailed histopathologic studies coupled with sophisticated cytogenetic techniques have established the presence of two distinct syndromes of molar disease. A complete mole is consistently associated with a totally paternally derived diploid genotype (diandric diploidy), while a partial mole is associated with complete triploidy that incorporates an extra haploid paternal chromosomal complement (diandric triploidy). […] It is important to recognize distinctions between these two molar syndromes, since they are associated with distinct clinical presentations and different risks for the subsequent development of malignant sequelae.

• #26 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Chemotherapy is ultimately required for persistence or neoplastic transformation in about 15% to 20% of patients after evacuation of a complete HM but for fewer than 5% of patients with partial HM. […] Studies have shown that a single course of prophylactic dactinomycin or methotrexate can decrease the risk of a postmolar gestational trophoblastic disease (GTD). […] There are distinctions in underlying biology between PSTTs and the other gestational trophoblastic tumors, particularly resistance to chemotherapy, that justify specific treatment strategies.

• #27 Gestational trophoblastic disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gestational-trophoblastic-disease/

  The risk of malignant GTN is higher in complete mole than in partial mole. […] Complete mole is the result of paternal disomy. Partial mole is the result of triploidy. […] Etiology: Fertilization of an empty egg that does not carry any chromosomes by a single sperm. […] Fertilization of an egg containing a haploid set of chromosomes with two sperms. […] The risk of progression to an invasive mole depends on the type of initial hydatidiform mole. […] Complete mole: 15-20% risk of subsequent invasive mole. […] Invasive mole: a form of GTD characterized by the malignant transformation of an incomplete or complete mole.

• #28 Gestational trophoblastic disease – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_trophoblastic_disease

  The term persistent trophoblastic disease (PTD) is used when after treatment of a molar pregnancy, some molar tissue is left behind and again starts growing into a tumour. Although PTD can spread within the body like a malignant cancer, the overall cure rate is nearly 100%. […] The treatment for invasive mole or choriocarcinoma generally is the same. Both are usually treated with chemotherapy. Methotrexate and dactinomycin are among the chemotherapy drugs used in GTD. […] Choriocarcinoma, for example, is an uncommon, yet almost always curable cancer. Although choriocarcinoma is a highly malignant tumour and a life-threatening disease, it is very sensitive to chemotherapy.

• #29 Gestational Trophoblastic Disease | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is a group of rare tumors that begin during a pregnancy. These tumors start in the cells that would normally develop into the placenta, which connects the fetus to the uterus. […] GTD can be benign (not cancerous) or malignant (cancerous). […] In contrast, all choriocarcinomas, PSTTs, and ETTs are considered cancerous. […] A choriocarcinoma is even rarer than a hydatidiform mole. This type of GTD may have begun as a hydatidiform mole or may arise from tissue that remains in the uterus following a miscarriage or full-term delivery of a baby. […] Unlike a hydatidiform mole, a choriocarcinoma is a malignant and more aggressive form of GTD that spreads into the muscle wall of the uterus. A choriocarcinoma can also spread more widely to other parts of the body such as the lungs, liver, and/or brain.

• #30 Gestational choriocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_choriocarcinoma

  Many efforts have been made to try to understand the mechanism of how non-malignant mole could become invasive. […] It is suspected that activation of certain oncogenes (such as up-regulations of MDM2, c-ERB2, and BLC2) and inactivation of tumor suppressor genes (such as up-regulations of p53, p21) were involved in the processes of genetic changes in this malignant transformation. […] Therefore, it is still unclear how significantly these genetic changes are in the pathogenesis of gestational choriocarcinoma.

• #31 Gestational Trophoblastic Disease | Clinical Gate

  https://clinicalgate.com/gestational-trophoblastic-disease-2/

  Several growth factors and oncogenes have been studied in molar tissues and CCA. […] Increased expression of p53 and c-fms has been observed in CHM, and increased ras and c-myc RNAs have been measured in CCA. […] The p53 gene was studied to detect any mutation in 22 complete moles and 11 CCAs that had increased expression of p53. […] Although studies have identified increased expression of several growth factors in GTN, the precise molecular pathogenesis has not been determined. […] Certain genes are expressed normally on either the maternal or paternal allele, and this occurrence is described as parental imprinting. […] Modification of parental imprinting has been associated with tumor formation; both complete moles and CCA have relaxation of parental imprinting.

• #32

  https://journals.lww.com/greenjournal/fulltext/2021/02000/gestational_trophoblastic_disease__current.22.aspx

  Gestational trophoblastic disease is a spectrum of interrelated disease processes originating from the placenta. […] Gestational trophoblastic neoplasia refers to lesions that have the potential for local invasion and metastasis. […] Before the development of sensitive assays for human chorionic gonadotropin (hCG) and effective chemotherapy, mortality from all forms of malignant gestational trophoblastic neoplasia was substantial. […] Germline mutations in NLRP7 and KHDC3L are observed in 48-80% and 10-14% of patients with repetitive moles, respectively. […] These are maternal effect genes, and mutations cause defects in maternal imprinting potentially resulting in defective oocytes and possible creation of a maternal environment hostile to embryonic implantation. […] The p57 cyclin-dependent kinase inhibitor is a paternally imprinted but maternally expressed gene.

• #33 Gestational choriocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_choriocarcinoma

  Statistics from clinical cases have shown that GC is associated with any pregnancy events, with 50% of GC arise from hydatidiform moles, 25% from gestation, and 25% from abortion or tubal pregnancy. […] The precise underlying causes of this disease remain incompletely understood, primarily due to its rarity and clinical challenges in distinguishing it from invasive mole, another type of trophoblastic tumor that shares similarities with gestational choriocarcinoma (GC). […] Despite these complexities, several risk factors have been identified and reported to be associated with gestational choriocarcinoma. […] At the cellular level, any abnormalities in the placental trophoblastic proliferation could potentially contribute to molar pregnancy and tumor development. […] Malignant cellular transformation of all of these three trophoblastic cells contribute to the development of gestational choriocarcinoma.

• #34 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Gestational trophoblastic disease (GTD) can be benign or malignant. Histologically, it is classified into hydatidiform mole, invasive mole (chorioadenoma destruens), choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Those that invade locally or metastasize are collectively known as gestational trophoblastic neoplasia (GTN). Hydatidiform mole is the most common form of GTN. While invasive mole and choriocarcinoma are malignant, a hydatidiform mole can behave in a malignant or benign fashion. […] A hydatidiform mole is considered malignant when the serum hCG levels plateau or rise during the follow-up period and an intervening pregnancy is excluded. This occurs in 15-20% of hydatidiform moles. […] Histologically, choriocarcinomas have no villi, but they have sheets of trophoblasts and hemorrhage. Choriocarcinomas are aneuploid and can be heterozygous depending on the type of pregnancy from which the choriocarcinoma arose. If a hydatidiform mole preceded the choriocarcinoma, the chromosomes are of paternal origin. Maternal and paternal chromosomes are present if a term pregnancy precedes the choriocarcinoma. Of choriocarcinomas, 50% are preceded by a hydatidiform mole, 25% by an abortion, 3% by ectopic pregnancy, and the other 22% by a full-term pregnancy. […] The most frequent sites of metastases of malignant gestational trophoblastic neoplasia are the lungs, lower genital tract, brain, liver, kidney, and gastrointestinal tract.

• #35 Persistent trophoblastic disease and choriocarcinoma | nidirect

  https://www.nidirect.gov.uk/conditions/persistent-trophoblastic-disease-and-choriocarcinoma

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours. They are known as gestational trophoblastic tumours (GTTs). […] This is known as persistent trophoblastic disease. […] Choriocarcinoma is a very rare type of cancer that occurs in around one in 50,000 pregnancies. It can develop if the cells left behind after a pregnancy become cancerous. […] It can happen several months, or even years, after a pregnancy. […] Although choriocarcinoma starts in the womb, it can spread to other parts of the body, most commonly, the lungs.

• #36 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Gestational trophoblastic disease (GTD) can be benign or malignant. Histologically, it is classified into hydatidiform mole, invasive mole (chorioadenoma destruens), choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Those that invade locally or metastasize are collectively known as gestational trophoblastic neoplasia (GTN). Hydatidiform mole is the most common form of GTN. While invasive mole and choriocarcinoma are malignant, a hydatidiform mole can behave in a malignant or benign fashion. […] A hydatidiform mole is considered malignant when the serum hCG levels plateau or rise during the follow-up period and an intervening pregnancy is excluded. This occurs in 15-20% of hydatidiform moles. […] Histologically, choriocarcinomas have no villi, but they have sheets of trophoblasts and hemorrhage. Choriocarcinomas are aneuploid and can be heterozygous depending on the type of pregnancy from which the choriocarcinoma arose. If a hydatidiform mole preceded the choriocarcinoma, the chromosomes are of paternal origin. Maternal and paternal chromosomes are present if a term pregnancy precedes the choriocarcinoma. Of choriocarcinomas, 50% are preceded by a hydatidiform mole, 25% by an abortion, 3% by ectopic pregnancy, and the other 22% by a full-term pregnancy. […] The most frequent sites of metastases of malignant gestational trophoblastic neoplasia are the lungs, lower genital tract, brain, liver, kidney, and gastrointestinal tract.

• #37 Pathology Outlines – Choriocarcinoma

  https://www.pathologyoutlines.com/topic/placentachoriocarcinoma.html

  Arises from trophoblastic cells of previous pregnancy, most commonly after complete hydatidiform mole (Int J Gynaecol Obstet 2018;143:79) […] Intraplacental choriocarcinoma can occur after nonmolar pregnancies, usually in the third trimester or postpartum […] Also arises less commonly after nonmolar miscarriages and ectopic pregnancies (Int J Gynaecol Obstet 2018;143:79, Case Rep Obstet Gynecol 2018;2018:4705192)

• #38

  https://journals.lww.com/greenjournal/fulltext/2021/02000/gestational_trophoblastic_disease__current.22.aspx

  In complete moles that lack maternal genome, p57 is not expressed. […] In contrast, partial moles and nonmolar gestations have maternal genome and do express the p57 gene. […] Postmolar gestational trophoblastic neoplasia is diagnosed more frequently after complete than partial moles. […] The role of repeat DE in the setting of an hCG rise or plateau is controversial. […] Patients with persistent histologic evidence of gestational trophoblastic disease at second curettage and those with hCG levels greater than 1,500 international units/L were significantly less likely to respond to the second curettage. […] Gestational choriocarcinoma is a pure epithelial malignancy, comprising neoplastic intermediate trophoblast, cytotrophoblast, and syncytiotrophoblast elements without chorionic villi.

• #39 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Gestational trophoblastic disease (GTD) can be benign or malignant. Histologically, it is classified into hydatidiform mole, invasive mole (chorioadenoma destruens), choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Those that invade locally or metastasize are collectively known as gestational trophoblastic neoplasia (GTN). Hydatidiform mole is the most common form of GTN. While invasive mole and choriocarcinoma are malignant, a hydatidiform mole can behave in a malignant or benign fashion. […] A hydatidiform mole is considered malignant when the serum hCG levels plateau or rise during the follow-up period and an intervening pregnancy is excluded. This occurs in 15-20% of hydatidiform moles. […] Histologically, choriocarcinomas have no villi, but they have sheets of trophoblasts and hemorrhage. Choriocarcinomas are aneuploid and can be heterozygous depending on the type of pregnancy from which the choriocarcinoma arose. If a hydatidiform mole preceded the choriocarcinoma, the chromosomes are of paternal origin. Maternal and paternal chromosomes are present if a term pregnancy precedes the choriocarcinoma. Of choriocarcinomas, 50% are preceded by a hydatidiform mole, 25% by an abortion, 3% by ectopic pregnancy, and the other 22% by a full-term pregnancy. […] The most frequent sites of metastases of malignant gestational trophoblastic neoplasia are the lungs, lower genital tract, brain, liver, kidney, and gastrointestinal tract.

• #40 Gestational trophoblastic disease | Causes, Symptoms & Treatment | Britannica

  https://www.britannica.com/science/gestational-trophoblastic-disease

  gestational trophoblastic disease, any of a group of rare conditions in which tumours develop in the uterus from the cells that normally would form the placenta during pregnancy. […] In rare cases, a hydatidiform mole progresses, continuing to grow after the pregnancy is terminated (usually as a result of abortion). This condition, persistent gestational trophoblastic disease, occurs when the hydatidiform mole has penetrated into the myometrium (the muscle layer surrounding the uterus) and therefore cannot be removed surgically. Persistent gestational trophoblastic disease may take the form of a choriocarcinoma, an invasive mole, or a placental-site trophoblastic tumour. […] Although about half of choriocarcinomas begin as molar pregnancies, they may also occur following abortion, miscarriage (spontaneous abortion), tubal pregnancy (the ovum becomes implanted in one of the fallopian tubes), or healthy pregnancy.

• #41 Gestational Trophoblastic Disease molar pregnancy

  https://www.mylifehouse.org.au/departments/gynae-oncology-2-2/gestational-trophoblastic-disease/

  In this very rare cancer, the trophoblast cells become totally disorganised and can invade and spread. […] Choriocarcinomas are highly malignant cancers and need prompt diagnosis and treatment. […] The treatment for choriocarcinoma is generally with combination chemotherapy. […] In a normal pregnancy the trophoblast invades into and through the lining of the womb. […] Sometimes the trophoblast of a molar pregnancy invades much more deeply into the womb than it should. […] Partial and complete moles are described as precancerous tissue but doctors sometimes disagree as to whether an invasive mole is cancer.

• #42 Gestational Trophoblastic Diseases | GLOWM

  https://www.glowm.com/section-view/heading/Gestational%20Trophoblastic%20Diseases/item/262

  Choriocarcinoma is characterized by a dimorphic population of cytotrophoblast and syncytiotrophoblast elements. […] Gestational choriocarcinoma, similar to other forms of normal and abnormal trophoblast, readily invades into blood vessels, producing metastasis through hematogenous routes of dissemination. The embolic metastatic sites have a tendency to rapidly outgrow their blood supply, producing central necrosis, which can result in massive local hemorrhage. […] Gestational choriocarcinoma usually progresses rapidly and is fatal without treatment. […] The epidemiology of gestational choriocarcinoma has been less extensively studied, owing to problems in histologic control and fewer cases than those of hydatidiform mole. The single highest risk factor is prior hydatidiform mole; the incidence of choriocarcinoma is increased 1000-2000-fold compared with term pregnancy. […] Although the risk of choriocarcinoma was increased slightly for nonwhites, this was not statistically significant.

• #43 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Gestational trophoblastic disease (GTD) is a broad term encompassing both benign and malignant growths arising from products of conception in the uterus. […] The reported incidence of choriocarcinoma, the most aggressive form of GTD, is about 2 to 7 per 100,000 pregnancies. […] Two factors have consistently been associated with an increased risk of GTD: Maternal age and history of hydatidiform mole (HM). […] The most common antecedent pregnancy in GTD is that of an HM. […] Choriocarcinoma most commonly follows a molar pregnancy but can follow a normal pregnancy, ectopic pregnancy, or abortion, and it should always be considered when a patient has continued vaginal bleeding in the postdelivery period. […] Nearly all GTDs that are preceded by nonmolar pregnancies are choriocarcinomas; the rare exceptions generally are PSTTs.

• #44 Gestational trophoblastic disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/gestational-trophoblastic-disease?lang=us

  Gestational trophoblastic disease (GTD) results from the abnormal proliferation of trophoblastic tissue and encompasses a wide spectrum of diseases, including gestational choriocarcinoma. […] Gestational choriocarcinoma arises following known molar pregnancy (50%), miscarriage (30%), normal pregnancy (20%). […] Choriocarcinoma may look identical to hydatidiform mole. […] Choriocarcinoma tends to invade myometrium through venous plexuses. […] Patients often can present with multiple metastases without an easily identified primary, as it can often be small in an otherwise normal placenta. […] Metastases can occur in lungs: ~80%, vagina: ~30%, pelvis: 20%, liver and brain: ~10%.

• #45 Gestational Trophoblastic Diseases | GLOWM

  https://www.glowm.com/section-view/heading/Gestational%20Trophoblastic%20Diseases/item/262

  Choriocarcinoma is characterized by a dimorphic population of cytotrophoblast and syncytiotrophoblast elements. […] Gestational choriocarcinoma, similar to other forms of normal and abnormal trophoblast, readily invades into blood vessels, producing metastasis through hematogenous routes of dissemination. The embolic metastatic sites have a tendency to rapidly outgrow their blood supply, producing central necrosis, which can result in massive local hemorrhage. […] Gestational choriocarcinoma usually progresses rapidly and is fatal without treatment. […] The epidemiology of gestational choriocarcinoma has been less extensively studied, owing to problems in histologic control and fewer cases than those of hydatidiform mole. The single highest risk factor is prior hydatidiform mole; the incidence of choriocarcinoma is increased 1000-2000-fold compared with term pregnancy. […] Although the risk of choriocarcinoma was increased slightly for nonwhites, this was not statistically significant.

• #46 Low-risk persistent gestational trophoblastic disease treated with low-dose methotrexate: efficacy, acute and long-term effects | British Journal of Cancer

  https://www.nature.com/articles/6601422

  A recent proposal is that persistent gestational trophoblastic neoplasia should be diagnosed if the plateau of hCG lasts for 4 weeks or more, there is a rise of hCG on three consecutive weekly measurements over a period of 2 weeks or longer, there is a histological diagnosis of choriocarcinoma or the hCG level remains elevated for 6 months or longer (FIGO, 2002). […] Goldstein et al (1998), in an evaluation of the revised FIGO (1992) staging, concluded that single-agent chemotherapy is the preferred therapy in patients with nonmetastatic GTD who desire to preserve fertility, and that patients with low-risk metastatic disease involving the pelvis with or without lung metastases (low-risk FIGO stage II, III) also respond well. […] For many years UK centres have used the low-dose intramuscular methotrexate regimen.

• #47 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #48 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Gestational trophoblastic disease describes a group of rare pregnancy related disorders that span a spectrum of premalignant and malignant conditions. […] Both complete and partial moles have the potential for malignant transformation but the risk of GTN is higher for CHM (15-20%) than for PHM (0.5-1%). […] Choriocarcinoma is the most aggressive form of GTN with a reported incidence of one per 40000 pregnancies in Europe and North America compared with 9.2 per 40000 pregnancies in South East Asia. […] Although most invasive moles originate from a CHM, only 25% of choriocarcinoma and 25% PSTT and ETT derive from a molar pregnancy. […] The risk of developing choriocarcinoma after a molar pregnancy is higher for CHM (23%) than PHM (1%). […] Hence, gestational choriocarcinoma should be considered in all premenopausal women with metastases of an unknown primary.

• #49 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #50 Gestational Trophoblastic Disease Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062901

  The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the following: Histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #51

  https://zana.com/a/persistent-trophoblastic-disease-choriocarcinoma.6089

  Choriocarcinoma can develop if the cells left behind after a pregnancy become cancerous. This can happen after any pregnancy, but it is more likely after molar pregnancies. […] Persistent trophoblastic disease and choriocarcinoma are very rare and are part of a group of tumours called gestational trophoblastic tumours (GTTs. […] Both persistent trophoblastic disease and choriocarcinoma are very rare. If you have had a molar pregnancy, you will be monitored closely in case you develop either of these conditions. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent, and 98-100% of women who develop a gestational trophoblastic cancer are cured.

• #52 Persistent trophoblastic disease and choriocarcinoma – Know Your Doctor

  https://www.knowyourdoctor.com.cy/medical/persistent-trophoblastic-disease-and-choriocarcinoma/

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours known as gestational trophoblastic tumours (GTTs). […] Choriocarcinoma can develop if the cells left behind after a pregnancy become cancerous. This can happen after any pregnancy, but it is more likely after molar pregnancies. […] If you have had a complete molar pregnancy, you have about a 1 in 10 chance of developing either persistent trophoblastic disease or choriocarcinoma. If you have had a partial molar pregnancy, the risk is around 1 in 100. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent, and 98-100% of women who develop a gestational trophoblastic cancer are cured.

• #53 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #54 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #55 Gestational Trophoblastic Disease Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062901

  The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved. […] The probability of cure depends on the following: Histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues.

• #56 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Chemotherapy is ultimately required for persistence or neoplastic transformation in about 15% to 20% of patients after evacuation of a complete HM but for fewer than 5% of patients with partial HM. […] Studies have shown that a single course of prophylactic dactinomycin or methotrexate can decrease the risk of a postmolar gestational trophoblastic disease (GTD). […] There are distinctions in underlying biology between PSTTs and the other gestational trophoblastic tumors, particularly resistance to chemotherapy, that justify specific treatment strategies.

• #57 Gestational Trophoblastic Disease Treatment (PDQ®): Treatment – Health Professional Information [NCI] – Health Information Library | PeaceHealth

  https://www.peacehealth.org/medical-topics/id/ncicdr0000062901

  Chemotherapy is ultimately required for persistence or neoplastic transformation in about 15% to 20% of patients after evacuation of a complete HM but for fewer than 5% of patients with partial HM. […] The use of chemotherapy in the first-line management of low-risk GTN has been assessed in a Cochrane Collaboration systematic review. […] Multiagent chemotherapy is standard for the initial management of high-risk gestational trophoblastic neoplasia (GTN). […] There are distinctions in underlying biology between PSTTs and the other gestational trophoblastic tumors, particularly resistance to chemotherapy, that justify specific treatment strategies.

• #58 Gestational trophoblastic disease – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_trophoblastic_disease

  The term persistent trophoblastic disease (PTD) is used when after treatment of a molar pregnancy, some molar tissue is left behind and again starts growing into a tumour. Although PTD can spread within the body like a malignant cancer, the overall cure rate is nearly 100%. […] The treatment for invasive mole or choriocarcinoma generally is the same. Both are usually treated with chemotherapy. Methotrexate and dactinomycin are among the chemotherapy drugs used in GTD. […] Choriocarcinoma, for example, is an uncommon, yet almost always curable cancer. Although choriocarcinoma is a highly malignant tumour and a life-threatening disease, it is very sensitive to chemotherapy.

• #59 Low-risk persistent gestational trophoblastic disease treated with low-dose methotrexate: efficacy, acute and long-term effects | British Journal of Cancer

  https://www.nature.com/articles/6601422

  We acknowledge that the etoposide component of our second-line chemotherapy regimen potentially puts these patients at risk of myelodysplastic disorders. […] In conclusion, methotrexate achieves high CR rates for low-risk persistent gestational trophoblastic disease. […] There does not appear to be an increased risk of second cancers, and fertility is preserved.

• #60

  https://journals.lww.com/greenjournal/fulltext/2021/02000/gestational_trophoblastic_disease__current.22.aspx

  Cytologic atypia is common and most cases have high mitotic counts. […] Patients with gestational choriocarcinomas tend to develop early systemic metastasis, and chemotherapy is almost always indicated when histologically diagnosed, even in the absence of metastases. […] Placental site trophoblastic tumor is usually diagnosed by DE or hysterectomy. […] Epithelioid trophoblastic tumors are very rare and most often histologically diagnosed by curettage or cervical biopsy. […] In general, placental site trophoblastic tumors and epithelioid trophoblastic tumors can occur after any type of antecedent pregnancy. […] The majority of patients who present with these lesions confined to the uterus are treated by hysterectomy. […] The primary treatment for most forms of gestational trophoblastic neoplasia is chemotherapy, based on the individual patients risk.

• #61

  https://journals.lww.com/greenjournal/fulltext/2021/02000/gestational_trophoblastic_disease__current.22.aspx

  The overall cure rate for patients with low-risk disease approaches 100% with recurrence rates less than 5%. […] Patients with a FIGO risk score of 7 or higher should initially be treated with aggressive multiagent chemotherapy; surgery or radiation or both are often incorporated into treatment. […] Multiagent regimens incorporate etoposide, with or without cisplatin, into cyclical combination chemotherapy with high rates of success and lower acute toxicity. […] Recently, programmed death ligand 1 has been identified in almost all gestational trophoblastic disease lesions and there are reports of patients with drug resistant gestational trophoblastic neoplasia salvaged with check-point inhibition using immunotherapy.

• #62 Gestational Trophoblastic Disease | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/gestational-trophoblastic-disease.html

  Gestational trophoblastic disease (GTD) is a group of rare tumors that develop from placental tissue. […] While most GTD tumors are benign (noncancerous), some may become malignant (cancerous). […] The only way to prevent GTD is not to become pregnant. […] Choriocarcinoma: This cancerous tumor forms from trophoblast cells and can spread into the muscles of the uterus, nearby blood vessels, and other organs. It can grow and spread more quickly than other GTNs. Sometimes choriocarcinomas develop from tissue left in the uterus after a miscarriage or delivering a healthy baby. […] Some factors can increase a woman’s risk of developing gestational trophoblastic disease. They include: Being pregnant when you are younger than 20 or older than 35, Having had a previous molar pregnancy, Previous miscarriage, Women from Southeast Asia and those with low dietary carotene also have a higher risk of molar pregnancy and GTN.

• #63

  http://www.bccancer.bc.ca/health-info/types-of-cancer/pelvic-area/gestational-trophoblastic-neoplasia

  Gestational Trophoblastic Neoplasia (GTN) describes a range of diseases including: benign hydatidiform mole (also known as molar pregnancy), invasive mole, choriocarcinoma and placental site tumour. […] Gestational trophoblastic tumours form from the cells that would normally become the placenta during pregnancy. […] There is a higher chance of a complete hydatidiform mole turning into an invasive mole or choriocarcinoma, than the partial hydatidiform mole. […] Choriocarcinoma is an aggressive tumour that can grow quickly and spread to other parts of the body. […] A tumour develops from the tissue that started as a hydatidiform mole, or tissue that is still in the uterus after treatment for hydatidiform mole. […] What causes GTN and who gets it? These are the risk factors for this cancer. Not all of these risk factors may cause this cancer, but they may help the cancer start growing. […] If a person has had a previous hydatidiform mole (molar pregnancy), it may increase their risk of developing a gestational trophoblastic tumour or another hydatidiform mole. […] There is no known way to prevent this disease. It is rare. […] There is no screening for this disease.

• #64

  https://zana.com/a/persistent-trophoblastic-disease-choriocarcinoma.6089

  Choriocarcinoma can develop if the cells left behind after a pregnancy become cancerous. This can happen after any pregnancy, but it is more likely after molar pregnancies. […] Persistent trophoblastic disease and choriocarcinoma are very rare and are part of a group of tumours called gestational trophoblastic tumours (GTTs. […] Both persistent trophoblastic disease and choriocarcinoma are very rare. If you have had a molar pregnancy, you will be monitored closely in case you develop either of these conditions. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent, and 98-100% of women who develop a gestational trophoblastic cancer are cured.

• #65 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  Chemotherapy is ultimately required for persistence or neoplastic transformation in about 15% to 20% of patients after evacuation of a complete HM but for fewer than 5% of patients with partial HM. […] Studies have shown that a single course of prophylactic dactinomycin or methotrexate can decrease the risk of a postmolar gestational trophoblastic disease (GTD). […] There are distinctions in underlying biology between PSTTs and the other gestational trophoblastic tumors, particularly resistance to chemotherapy, that justify specific treatment strategies.

• #66 Gestational Trophoblastic Diseases | GLOWM

  https://www.glowm.com/section-view/heading/Gestational%20Trophoblastic%20Diseases/item/262

  Several case-control studies have suggested a possible dietary factor in the etiology of hydatidiform mole. […] However, Brinton and colleagues were unable to find any dietary effect on the incidence of hydatidiform mole in China. […] It has been established that complete moles result from diandric diploidy; the egg is usually fertilized by a single sperm and loses the maternal haploid 23,X genetic component by an unknown mechanism. […] Partial moles most often result from dispermic fertilization of an egg with the retention of the maternal haploid set, resulting in diandric triploidy. […] The role of prophylactic chemotherapy, given at or prior to the time of molar evacuation to prevent postmolar GTT remains controversial. […] Therefore, many investigators have believed that routine application of prophylactic chemotherapy is not warranted in the management of most patients with hydatidiform moles.

• #67 Gestational trophoblastic diseases | PPT

  https://www.slideshare.net/slideshow/gestational-trophoblastic-diseases-173278673/173278673

  Gestational trophoblastic disease is a heterogeneous group of lesions arising from abnormal placental trophoblast proliferation. […] GTN arises when the normal regulatory mechanisms controlling the proliferation and invasiveness of trophoblastic tissue are lost. […] Choriocarcinoma is a malignant form that can develop from any type of pregnancy and has a high risk of metastasis. […] Diagnosis involves elevated hCG levels, imaging, and histopathology. […] Treatment depends on the type and severity but may include suction dilation and curettage, chemotherapy, and radiation therapy. […] GTN has varying potential for local invasion and metastasis. […] The long term prognosis for women with a H. Mole is not improved with prophylactic chemotherapy. […] High-risk cases when follow up are unavailable or unreliable may benefit from prophylactic chemotherapy.

• #68 Information about molar pregnancy | Imperial College Healthcare NHS Trust

  https://www.imperial.nhs.uk/our-services/cancer-services/gestational-trophoblastic-disease/information-about-molar-pregnancy

  Although some studies have linked molar pregnancy with dietary or genetic factors, the real cause of molar pregnancy is still unknown. […] Molar pregnancies carry a risk of developing into persistent trophoblastic disease which needs further treatment, most commonly with chemotherapy. […] While we generally do not do a further biopsy to prove it, if measuring samples indicates that the hCG level is rising and we decide to start treatment, we would regard you as having persistent trophoblastic disease, or choriocarcinoma, a very rare form of cancer. […] The most frequent choice is chemotherapy. This approach is usually very simple, generally has few side effects, allows patients to retain their fertility and has a cure rate of over 99 per cent.

• #69 Epidemiology and aetiology of gestational trophoblastic diseases – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14602247/

  Gestational trophoblastic diseases (GTD) consist of a group of neoplastic disorders arising from placental trophoblastic tissue after normal or abnormal fertilisation. […] Maternal age and a history of GTD have been established as strong risk factors for hydatidiform mole and choriocarcinoma. […] We review published data on the worldwide distribution of GTD, original data from cancer-registry-based statistics on choriocarcinoma, and major aetiological hypotheses, including parental age, AB0 blood groups, history of GTD, reproductive factors, oral contraceptive use, and other environmental factors.

• #70 Persistent Trophoblastic Disease (Choriocarcinoma) | Symptoms, Diagnosis & Causes | Conditions | Healthera

  https://healthera.co.uk/conditions-a-z/persistent-trophoblastic-disease-choriocarcinoma/

  Persistent trophoblastic disease, also known as choriocarcinoma, is a rare type of cancer that can occur after pregnancy. It develops from a tissue that normally forms the placenta. […] Persistent trophoblastic disease refers to a group of conditions that arise when cells that usually help to support a pregnancy turn into cancerous cells. Choriocarcinoma is one type of this disease and can develop after a pregnancy, particularly if there were complications. […] The exact cause of choriocarcinoma is not clear. It often develops from a condition called a hydatidiform mole, which is an abnormal growth of tissue in the uterus that can happen during pregnancy. Sometimes it can also arise after a normal pregnancy.

• #71

  https://zana.com/a/persistent-trophoblastic-disease-choriocarcinoma.6089

  Choriocarcinoma can develop if the cells left behind after a pregnancy become cancerous. This can happen after any pregnancy, but it is more likely after molar pregnancies. […] Persistent trophoblastic disease and choriocarcinoma are very rare and are part of a group of tumours called gestational trophoblastic tumours (GTTs. […] Both persistent trophoblastic disease and choriocarcinoma are very rare. If you have had a molar pregnancy, you will be monitored closely in case you develop either of these conditions. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent, and 98-100% of women who develop a gestational trophoblastic cancer are cured.

• #72 Case Study: Gestational Trophoblastic Disease – O&G Magazine

  https://www.ogmagazine.org.au/27/1-27/case-study-gestational-trophoblastic-disease-diagnostic-dilemmas-and-management-challenges/

  Discrepancy between imaging findings and hysteroscopic evaluation in cases of suspected retained products of conception warrants further evaluation with serial -hCG and further imaging. […] Management of GTD/GTN almost always requires a multidisciplinary approach including gynaecologists, gynaecological-oncologists, medical oncologists, radiologists, gynaecological-pathologists, nursing teams and support networks. Various societies have outlined guidelines for the management. Clinicians in Australia and Aotearoa New Zealand are encouraged to follow the RANZCOG guidelines.

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