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TrophoVerse

GTD arises from abnormal placenta

Gestational trophoblastic disease (GTD) is a group of uncommon conditions associated with pregnancy. The pathogenesis of GTD is unique, because the maternal lesions arise from fetal, not maternal, tissue.

GTD encompasses the non-neoplastic entities, placental site nodules (PSN) and exaggerated placental site (EPS) tumours; the premalignant hydatidiform moles (HMs) which have the potential for persistence and invasion; and the malignant invasive mole, choriocarcinoma, placental-site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT) which are collectively known as gestational trophoblastic neoplasia (GTN). 

Hydatidiform mole is an abnormal pregnancy

Hydatidform mole (HM) originates in the villous trophoblast and it is characterized by abnormal chorionic villi with trophoblast hyperplasia as a consequence of overexpression of paternal genes, and associated with an absent or abnormal fetus/embryo. Molar pregnancies, although benign, are considered to be premalignant because they have the potential to develop into a malignancy. It has two histologically distinct subtypes, complete (CHM) and partial (PHM).

GTN is highly curable, even in the setting of advanced disease and widespread metastases.

Gestational trophoblastic neoplasia (GTN) is one of the rare human malignancies that is curable, with cure rates of 90-100% even in the presence of widespread disease. Unlike other malignancies, GTN does not necessarily need histologic confirmation, and is the only malignancy diagnosed based on a serum assay, the BhCG. All types of GTN originate from the placenta. Approximately 50% of GTN cases arise after a molar pregnancy, whereas 25% may develop after miscarriage, termination, or ectopic pregnancy; the remaining 25% may result after a preterm or term pregnancy.

  • GTD Classification (Lok 2021)

  • Risk Factors for Hydatidiform Mole (Lurain 2019)

  • Features of Complete and Partial Moles (Soper 2021)

  • Risk Factors for Developing Postmolar GTN (CPG for HM in the Philippines 2022)

  • Contraindications to Chemoprophylaxis (CPG for HM in the Philippines 2022)

  • BhCG Monitoring for Complete and Partial Moles (CPG for HM in the Philippines 2022)

  • Criteria for the Diagnosis of Postmolar GTN (CPG for HM in the Philippines 2022)

  • Clinical Presentations of Gestational Choriocarcinoma (Mangla 2017)

  • TVS with Doppler Studies GTN (Dhanda 2014)

  • Pathogenesis of GTN (Shih 2007)

  • GTN FIGO 2000 Anatomic Staging

  • GTN WHO Prognostic Scoring System

  • Response to Treatment

  • WHO Common Toxicity Grade

  • BhCG Monitoring for GTN Patients in Remission

Listen up.

Worn to a frazzle? Book burn-out? Lacking focus?

We got you.

Introducing, the course’s newest add-on, the TrophoVoice.  Give ear to our treasure trove of trophoblastic disease lectures which are regularly updated.
Give it a go. There’s not a moment to lose.

Professor Arthur T. Hertig, Department of Pathology, Harvard Medical School;

referring to gestational trophoblastic neoplasia (GTN):

“God’s first cancer, man’s first cure.”

Triviatastic Fun!

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