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Gestational Trophoblastic Disease and Choriocarcinoma

Ruben Salinas, Jr., MD, FAAFP, Vanessa M. Rivera, MD and Jacob C. Shook, DO Reviewed 06/2018
 


BASICS

DESCRIPTION

Gestational trophoblastic disease (GTD) is a group of rare conditions associated with pregnancy that consists of abnormal overgrowth of the placental trophoblast tissue. The most com...

DIAGNOSIS

HISTORY

  • Most common symptom: vaginal bleeding around 6 to 16 weeks, 80–90% of CM, 75% of PM (1)

  • Hyperemesis (8% CM) (1)

  • History of missed or incomplete abortion (90% of patients with PM) (1)

  • His...

TREATMENT

GENERAL MEASURES

  • Chemotherapy with or without surgery are mainstay therapies based on stage and risk score.

  • Consider the following potential indications for initiating chemotherapy:

    • Rising or p...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Ambulatory as tolerated 

Patient Monitoring

  • Goal: Achieve three consecutive weekly undetectable hCG levels after chemotherapy (3).

    • Monthly serum quantitative hCG lev...

REFERENCES

1
Lurain JR. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. Am J...

CODES

ICD10

  • O01.0 Classical hydatidiform mole

  • O01.1 Incomplete and partial hydatidiform mole

  • O01.9 Hydatidiform mole, unspecified

  • O01 Hydatidiform mole

  • C58 Malignant neoplasm of placenta

  • D39.2 Neoplasm of u...

CLINICAL PEARLS

  • High levels of quantitative HCG levels should arise suspicion for GTD.

  • Pelvic ultrasound preferred modality for evaluation of suspected GTD

  • Staging and risk score directs therapy type.

  • Hi...

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