Materiały źródłowe

• #1 Gestational trophoblastic disease: Pathology and genetics – UpToDate

  https://www.uptodate.com/contents/gestational-trophoblastic-disease-pathology-and-genetics

  Gestational trophoblastic disease (GTD) and gestational trophoblastic neoplasia (GTN) comprise a heterogeneous group of related lesions arising from abnormal cellular proliferation of placental trophoblasts. Most, but not all, of these lesions produce human chorionic gonadotropin (hCG) at some level. The pathogenesis of GTD/GTN is unique because maternal lesions arise from fetal, not maternal, tissue, making them genetically distinct from the maternal host, and distinguishing them from other tumorous processes. Consequently, understanding the histomorphology, immunohistochemistry, and genetics of GTD/GTN is central to their diagnosis, prognosis, and clinical management. […] The histopathology of GTD is discussed here. The epidemiology, clinical manifestations, diagnosis, and treatment of hydatidiform moles and malignant GTD are reviewed separately.

• #2 Gestational Trophoblastic Neoplasia, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 17 Issue 11 (2019)

  https://jnccn.org/view/journals/jnccn/17/11/article-p1374.xml?rskey=5YhKq2&result=6&print

  Gestational trophoblastic disease (GTD) refers to a group of benign and malignant tumors that develop in the uterus from placental tissue. Pathogenesis of GTD is unique in that maternal tumors arise from gestational tissue that can have locally invasive or metastatic potential. […] Choriocarcinoma develops from villous trophoblast. Features of these malignant epithelial tumors include abnormal trophoblastic hyperplasia and anaplasia, hCG production, absence of chorionic villi, hemorrhage, and necrosis. […] The intermediate trophoblastic tumors (ITT), including PSTT and ETT, are rare subtypes of GTN with an incidence of about 1 in 100,000 pregnancies, representing approximately 1% of all GTN cases. […] ITTs can be differentiated from other types of GTN via their histopathologic characteristics. […] ETT is distinguished from PSTT by its smaller, fairly monomorphic cells and a nested, nodular, well-circumscribed growth pattern.

• #3 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%. […] In the vast majority of patients, treatment of PTD consist of chemotherapy. Only about 10% of patients with PTD can be treated successfully with a second curettage. […] 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. Virtually all women with non-metastatic disease are cured and retain their fertility; the prognosis is also very good for those with metastatic (spreading) cancer, in the early stages, but fertility may be lost.

• #4 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 heterogeneous group of disorders that arise from abnormal proliferation of placental trophoblastic tissue. […] 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. […] The risk of developing choriocarcinoma after a molar pregnancy is higher for CHM (23%) than PHM (1%). […] Identification of the origin of choriocarcinoma can be challenging and genetic profiling can help to differentiate gestational from non-gestational choriocarcinoma, with non-gestational choriocarcinoma having a worse prognosis.

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

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

  Methylation based silencing of Wnt signalling inhibitors might enable Wnt hyperactivation and facilitate trophoblast invasion reported in cases of CHM and choriocarcinoma. […] Use of checkpoint inhibitor immunotherapy (eg, pembrolizumab) for chemoresistant, very high risk GTN has had some success. […] Immunotherapy targets the T cell receptor, PD-L1, which is highly expressed on normal trophoblasts and all forms of GTN.

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

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

  The pathogenesis of GTD is unique as the maternal tumour arises from gestational tissue rather than maternal tissue. […] Choriocarcinoma can be gestational or non-gestational and both have different routes of metastasis and treatment regimens. […] Use of molecular genotyping to confirm the absence of paternal DNA can lead to an accurate classification of non-gestational choriocarcinomas. […] The treatment of invasive mole and choriocarcinoma is often initiated on the basis of a rising hCG level even in the absence of other clinical evidence of disease recurrence. […] The high expression of matrix metalloproteinases and low expression of their inhibitors in choriocarcinoma might explain its invasiveness and malignant potential. […] Similarly, the wingless signalling pathway (Wnt gene family), which regulates placental cell migration, might be implicated in trophoblastic disease.

• #5 Gestational Trophoblastic Disease | Oncohema Key

  https://oncohemakey.com/gestational-trophoblastic-disease/

  Gestational trophoblastic disease (GTD) comprises a wide spectrum of neoplastic disorders that arise from placental trophoblastic tissue after abnormal fertilization. […] Choriocarcinoma is associated with an antecedent complete hydatidiform mole in 50% of the cases, a history of abortion in 25%, term delivery in 20%, and ectopic pregnancy in 5%. […] Choriocarcinoma is a malignant tumor with a unique histology distinct from that of moles. […] The growth of choriocarcinomas may be related to the abundant expression of epidermal growth factor (EGF) receptor. […] The contribution of several oncogenes to the malignant transformation of GTD has also been examined. […] The excess of paternal chromosomes in moles probably contributes to the induction of trophoblastic hyperplasia. […] A complete mole contains nuclear chromosomes of paternal origin and mitochondrial DNA of maternal origin. […] A partial mole results from the abnormal union of two spermatozoa with one ovum with intact chromosomes, resulting in a triploid karyotype. […] Rarely, familial recurrent hydatidiform mole syndrome may be present, leading to recurrent molar pregnancies.

• #6 Gestational trophoblastic disease | Oncohema Key

  https://oncohemakey.com/gestational-trophoblastic-disease-7/

  Gestational trophoblastic tumours originate from placental tissues and are among the few human cancers that can be cured, even in the presence of widespread metastasis. […] The term gestational trophoblastic disease (GTD) covers hydatidiform molar pregnancies, invasive moles, choriocarcinomas and placental site trophoblastic tumours. […] Cytogenetic and molecular analysis of hydatidiform moles has provided a clue as to their origin. […] The majority of complete moles have a 46XX karyotype, with both X-chromosomes of paternal origin (androgenetic). […] In contrast, partial moles contain both maternal and paternal DNA and are typically triploid 69XXY, presumably as a result of fertilization of a single ovum by two sperm. […] It is thought that the developmental abnormality affecting uniparental diploid cells in complete moles (in this case androgenetic, 46XX) is due to genomic imprinting.

• #6 Gestational trophoblastic disease | Oncohema Key

  https://oncohemakey.com/gestational-trophoblastic-disease-7/

  The expression of some genes is determined by their parental origin whether the allele was inherited from the mother or father and this persists through multiple rounds of DNA amplification. […] This parent-of-origin effect is known as genomic imprinting and only affects a minority of genes. […] Choriocarcinoma, although rare, is an important diagnosis, as the tumour is exquisitely sensitive to chemotherapy and over 95% of women with this diagnosis can be cured. […] If choriocarcinoma follows a molar pregnancy, molecular analysis reveals that the tumour DNA is entirely androgenetic, being derived from the father, with the loss of all maternal alleles. […] In contrast, post-term choriocarcinoma has a biparental genotype, with DNA from both parents. […] Nonetheless, all cases of choriocarcinoma include paternal DNA sequences that are absent from the patients genome and this may be used to confirm the diagnosis genetically if necessary.

• #7 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

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

  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. […] […] The exact pathogenesis of choriocarcinoma has not been fully explained or understood, but studies have shown cytotrophoblastic cells function as stem cells and undergo malignant transformation. The neoplastic cytotrophoblast further differentiates into intermediate trophoblasts and syncytiotrophoblasts. Overexpression of p53 and MDM2 has been demonstrated in choriocarcinoma, with no evidence of somatic mutation. Other genes implicated with either overexpression or down-regulation via hyper-methylation include NECC1, epidermal growth factor receptor, DOC-2/hDab2, Ras GTPase-activating protein, E-cadherin, HIC-1, p16, and TIMP3. HLA-G is demonstrated at very high levels in choriocarcinoma and functions to change the tumor microenvironment through the inactivation of the local immune system. […]

• #8 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. […] 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. […] Choriocarcinoma is a malignant tumor of the trophoblastic epithelium. Uterine muscle and blood vessels are invaded with areas of hemorrhage and necrosis. […] Most choriocarcinomas have an aneuploid karyotype, and about three-quarters of them contain a Y chromosome. […] Nearly all GTDs that are preceded by nonmolar pregnancies are choriocarcinomas; the rare exceptions generally are PSTTs.

• #9 Gestational Trophoblastic Disease | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22233

  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. […] The exact pathogenesis of choriocarcinoma has not been fully explained or understood, but studies have shown cytotrophoblastic cells function as stem cells and undergo malignant transformation. The neoplastic cytotrophoblast further differentiates into intermediate trophoblasts and syncytiotrophoblasts. Overexpression of p53 and MDM2 has been demonstrated in choriocarcinoma, with no evidence of somatic mutation. Other genes implicated with either overexpression or down-regulation via hyper-methylation include NECC1, epidermal growth factor receptor, DOC-2/hDab2, Ras GTPase-activating protein, E-cadherin, HIC-1, p16, and TIMP3. HLA-G is demonstrated at very high levels in choriocarcinoma and functions to change the tumor microenvironment through the inactivation of the local immune system.

• #10 Gestational Trophoblastic Tumors

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

  In choriocarcinoma, increased expression of c-myc and ras RNA has been observed. […] Progression of some tumors has been associated with the inactivation of tumor suppressor genes. […] Expression of p53 in hydatidiform moles has recently been studied. Expression of p53 in moles was observed to be increased over that in normal trophoblasts. No p53 mutations were found.

• #10 Gestational Trophoblastic Tumors

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

  In addition, the roles of proto-oncogenes, tumor-suppressor genes, cytokines, and growth factors also are contributing to our understanding of GTT and tumor progression. […] Approximately 20% of complete moles give rise to persistent trophoblastic disease. […] The excess of paternal chromosomes in moles probably contributes to the induction of trophoblastic hyperplasia. The genomic imbalance may cause changes in the gene expression of growth factors located on the paternal allele. […] The growth of choriocarcinoma may be related to the abundant expression of epidermal growth factor (EGF) receptor. […] The contribution of several oncogenes to the malignant transformation of GTT also has been examined. Growth regulation in the trophoblast recently has been found to be associated with expression of the transcription factor Mash-2.

• #11 Gestational Trophoblastic Disease | Clinical Gate

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

  Extracellular proteinases such as matrix metalloproteinases (MMPs) are thought to be important in modulating both cell-matrix interactions and the degradation of the basement membrane necessary for invasion and metastases. CCA exhibits significantly stronger expression of MMP-1 and MMP-2 and decreased expression of tissue inhibitor of MMP-1 (TIMP-1) than are seen in the syncytiotrophoblast of complete and partial mole and normal placenta. […] 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.

• #12 Trophoblastic vasculogenic mimicry in gestational choriocarcinoma | Modern Pathology

  https://www.nature.com/articles/modpathol2010231

  Angiogenesis is a characteristic feature of solid tumors, which depend on the newly formed vasculature to prevent hypoxia and to sustain uncontrolled tumor cell proliferation. […] Previous morphological and immunohistochemical studies have suggested that choriocarcinoma develops as a result of neoplastic transformation of trophoblastic stem cells, presumably the cytotrophoblast. […] Molecularly, several genes and pathways have been reported to participate in the pathogenesis of choriocarcinoma. These include epidermal growth factor (EGF) receptor, DOC-2/hDab2 (a candidate tumor suppressor gene), the ras GTPase activating protein, c-myc, c-erb-2, c-fms, and bcl-2 oncoproteins. […] A plausible hypothesis is that HLA-G expressed by choriocarcinomas assists the escape of tumor cells from host immune recognition and promotes tumor growth.

• #12 Trophoblastic vasculogenic mimicry in gestational choriocarcinoma | Modern Pathology

  https://www.nature.com/articles/modpathol2010231

  Thus, trophoblastic cells likely substitute for angiogenesis in the development of choriocarcinoma. […] In conclusion, this study provides evidence that choriocarcinoma lacks new blood vessel formation in the center of the tumor. Rather, a choriocarcinoma establishes its own intricate pseudovascular networks that are lined by syncytiotrophoblastic cells rather than by endothelial cells. […] Finally, the utilization of vasculogenic mimicry, which is less effective than bona fide angiogenesis, can also explain the massive hemorrhage and necrosis that are frequently associated with choriocarcinoma.

• #13 Review of current literature on gestational trophoblastic neoplasia | Journal of the Egyptian National Cancer Institute | Full Text

  https://jenci.springeropen.com/articles/10.1186/s43046-023-00195-y

  Patients with GTN are divided into two broad categories – low-risk and high-risk. […] High-risk GTN includes Stage II and III patients with FIGO score seven and patients with metastatic disease on presentation. […] For the last two decades, multi-agent chemotherapy using etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine (EMA-CO) remains the standard of care treatment for patients with high-risk GTN. […] Almost all GTN tumor cells express programmed cell death ligand 1 (PD-L1). […] Current studies have suggested high expressions of PDL-1 in the normal placenta as well as on various histological subtypes of GTD.

• #14 Gestational choriocarcinoma – Wikipedia

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

  Malignant cellular transformation of all of these three trophoblastic cells contribute to the development of 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. […] Recent research in the role of long non-coding RNAs (lncRNAs) in the GC development is believed to bring hope in this field. Long non-coding RNAs are groups of RNAs that do not code for protein expression and are usually over 200 nucleotides long; they are increasingly recognized to have essential role in many aspects of cellular function, like transcriptional regulation, sub-cellular protein localization, and epigenetic remodeling. […] To date, several types of lncRNAs are reported to have role in GC pathogenesis, which are metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), H19, maternally expressed gene 3 (MEG3), prostate cancer antigen 3 (PCA3), the long intergenic non-coding RNA 00261 (LINC00261), etc.

• #15 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

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

  Choriocarcinomas are malignant hCG-releasing epithelial tumors with central necrosis and a characteristic biphasic structure. Intraplacental choriocarcinomas can also occur and are likely responsible for metastatic disease after term pregnancies. The majority of neonatal choriocarcinomas are a result of metastatic spread from intraplacental choriocarcinomas.

• #16 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 trophoblastic neoplasms. […] A common characteristic of all gestational trophoblastic disease is an abnormal proliferation of trophoblast, but different components predominate in different tumors. […] Gestational choriocarcinoma may look identical to hydatidiform mole. […] Gestational choriocarcinoma arises following known molar pregnancy (50%), miscarriage (30%), normal pregnancy (20%). […] Gestational 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%.

• #17 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.

• #18 What is invasive mole and choriocarcinoma? | Gestational trophoblastic disease (GTD) | Cancer Research UK

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

  Invasive mole and choriocarcinoma are both types of gestational trophoblastic disease. […] Invasive mole and choriocarcinoma are both cancerous types of GTD. […] This is called an invasive mole or persistent trophoblastic disease (PTD). This occurs in about 1 in 12 women (8%) after molar pregnancy treatment. […] A choriocarcinoma is a cancer that happens when cells that were part of a normal pregnancy or a molar pregnancy become cancerous. […] Choriocarcinoma is more common after a molar pregnancy. […] A choriocarcinoma can develop some months or even years after pregnancy. […] A choriocarcinoma can spread to other parts of the body, but is usually cured by chemotherapy treatment or surgery. […] The main known risk factor for invasive mole and choriocarcinoma is a previous molar pregnancy. […] The main treatment for invasive mole or choriocarcinoma is chemotherapy.

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

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

  Gestational trophoblastic neoplasia (GTN) is a collective term for gestational trophoblastic diseases that invade locally or metastasize. Hydatidiform mole is the most common form of GTN; others are invasive mole (chorioadenoma destruens), choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). […] 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.

• #20 Pathology Outlines – Complete hydatidiform mole

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

  15 – 20% risk of progressing to gestational trophoblastic neoplasia; 10 – 15% invasive mole, 2 – 3% choriocarcinoma. […] 50% of choriocarcinoma cases arise from complete mole. […] Progression risk is higher: Signs of trophoblastic proliferation (uterine size greater than gestational age, serum hCG levels > 100,000 milli-international units/mL, ovarian theca lutein cysts > 6 cm in diameter).

• #21 Pathology Outlines – Choriocarcinoma

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

  Aggressive form of gestational trophoblastic neoplasia composed of syncytiotrophoblast, cytotrophoblast and intermediate trophoblast […] Triphasic neoplasm (syncytiotrophoblast, cytotrophoblast and intermediate trophoblast components) […] Arises from previous pregnancies, more commonly after complete hydatidiform mole […] Arises from trophoblastic cells of previous pregnancy, most commonly after complete hydatidiform mole […] Intraplacental choriocarcinoma can occur after nonmolar pregnancies, usually in the third trimester or postpartum […] Markedly elevated hCG is a reliable marker of the disease […] hCG levels reflect the tumor burden, therefore, they are used for diagnosis, follow up, evaluation of therapy response and screening of recurrences […] Solid sheets of atypical syncytiotrophoblast, cytotrophoblast and intermediate trophoblast

• #22 Pathology Outlines – Choriocarcinoma

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

  Absence of chorionic villi […] Infiltrative and destructive pattern […] High mitotic activity […] Background of necrosis and hemorrhage […] Genotyping with short tandem repeat (STR) analysis can differentiate gestational and nongestational origin by documenting the presence of paternal alleles in gestational choriocarcinoma […] The majority has XX sex chromosomes and complex karyotypes.

• #23 Gestational trophoblastic neoplasia–pathogenesis and potential therapeutic targets – PubMed

  https://pubmed.ncbi.nlm.nih.gov/17613426/

  Gestational trophoblastic neoplasia comprises a unique group of human neoplastic diseases that derive from fetal trophoblastic tissues and represent semiallografts in patients. This group is composed of choriocarcinoma, placental-site trophoblastic tumour, and epithelioid trophoblastic tumour, and many forms are derived from the precursor lesions, hydatidiform moles. […] Although most patients with gestational trophoblastic neoplasia are cured by chemotherapy and tumour resection, some patients suffer from metastatic diseases that are refractory to conventional chemotherapy. Therefore, new therapeutic regimens are needed to reduce the toxic effects associated with current chemotherapy and to salvage the occasional non-operable patients with recurrent and chemoresistant disease. […] Until the fundamental biology of gestational trophoblastic neoplasia becomes more clearly understood, development of a new treatment will remain empirical. This review will briefly summarise the recent advances in understanding the molecular aetiology of this group of diseases and highlight the molecules that can be potentially used for therapeutic targets to treat metastatic gestational trophoblastic neoplasia.

• #24 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). […] But in a small number of women, the tissue can stay and grow further into the lining of the womb and, like a cancer, spread to other areas of the body. 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. […] Although choriocarcinoma starts in the womb, it can spread to other parts of the body, most commonly, the lungs. […] Chemotherapy is used to treat choriocarcinoma and usually successfully cures it. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent. 98 to 100 per cent of women who develop a gestational trophoblastic cancer are cured.

• #25 Pathogenesis of Gestational Trophoblastic Lesions | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-59745-346-2_10

  Gestational trophoblastic disease (GTD) can be broadly divided into two groups, hydatidiform moles, which represent abnormally formed placentas, and trophoblastic tumors, and tumor-like lesions. […] In contrast to hydatidiform moles, the pathogenesis of trophoblastic tumors and tumor-like lesions is largely unknown. […] The identification and characterization of the genes expressed in human trophoblast has led to a further understanding of the lineage and differentiation program of trophoblast and related this to trophoblastic lesions. […] It is now clear that trophoblastic lesions recapitulate the trophoblast present in the early developing placenta and implantation site. […] In this chapter, some of these recent observations will be summarized and correlated with the morphology and biology of human trophoblast in normal placentation and in trophoblastic disease.

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