Gestational trophoblastic neoplasia natural history, complications and prognosis: Difference between revisions
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==Natural history== | ==Natural history== | ||
* For choriocarcinoma, the average age of presentation is 33 years for Asian women and 28 years for American women. A history of multiple pregnancies (or molar pregnancy) carries an increased risk for the development of choriocarcinoma. | * For choriocarcinoma, the average age of presentation is 33 years for Asian women and 28 years for American women. A history of multiple pregnancies (or molar pregnancy) carries an increased risk for the development of choriocarcinoma. | ||
* Patient has early symptoms such as [[vaginal bleeding]], passing of tissue resembling a “bunch of grapes” from the vagina, the abdomen may grow at a much faster rate than with a normal pregnancy | * Patient has early symptoms such as [[vaginal bleeding]], passing of tissue resembling a “bunch of grapes” from the vagina, the abdomen may grow at a much faster rate than with a normal pregnancy.<ref name="urlGestational Trophoblastic Disease | SpringerLink">{{cite web |url=https://link.springer.com/chapter/10.1007/978-0-387-26321-2_4 |title=Gestational Trophoblastic Disease | SpringerLink |format= |work= |accessdate=}}</ref> | ||
* [[Nausea]] and [[vomiting]], and absent fetal movement during pregnancy. | * [[Nausea]] and [[vomiting]], and absent fetal movement during pregnancy are typical features of patients suffering from gestational trophoblastic neoplasia. | ||
* As the tumor grows larger, patient may notice symptoms like lump in the vagina, [[hemoptysis]], [[chest pain]], trouble breathing, [[headache]], [[dizziness]], [[jaundice]], [[paralysis]], [[seizure]], [[dysarthria]], and [[dysphasia]]. | * As the tumor grows larger, patient may notice symptoms like lump in the vagina, [[hemoptysis]], [[chest pain]], trouble breathing, [[headache]], [[dizziness]], [[jaundice]], [[paralysis]], [[seizure]], [[dysarthria]], and [[dysphasia]]. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.[1]
Natural history
- For choriocarcinoma, the average age of presentation is 33 years for Asian women and 28 years for American women. A history of multiple pregnancies (or molar pregnancy) carries an increased risk for the development of choriocarcinoma.
- Patient has early symptoms such as vaginal bleeding, passing of tissue resembling a “bunch of grapes” from the vagina, the abdomen may grow at a much faster rate than with a normal pregnancy.[2]
- Nausea and vomiting, and absent fetal movement during pregnancy are typical features of patients suffering from gestational trophoblastic neoplasia.
- As the tumor grows larger, patient may notice symptoms like lump in the vagina, hemoptysis, chest pain, trouble breathing, headache, dizziness, jaundice, paralysis, seizure, dysarthria, and dysphasia.
Prognosis
- 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.[1] [3]
- The probability of cure depends on the following:
- Histologic 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 metastasis
- Nature of antecedent pregnancy
- Extent of prior treatment
- Disease duration greater than four months from delivery, pretreatment hCG level > 100,000 mIU/mL, presence of liver or brain metastases, and a WHO score > 8 were all important predictors of outcome in patients with postterm choriocarcinoma
Complications
Gestational trophoblastic neoplasia maybe associated with the following complications:[4]
- Metastasis
- Recurrent pregnancy loss
- Hemoptysis
- Pneumothorax
- Anemia
- Hyperthyroidism
- Pre-eclampsia
References
- ↑ 1.0 1.1 General Information About Gestational Trophoblastic Disease. National Cancer Institute. http://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq Accessed on October 14, 2015
- ↑ "Gestational Trophoblastic Disease | SpringerLink".
- ↑ Rodabaugh KJ, Bernstein MR, Goldstein DP, Berkowitz RS (January 1998). "Natural history of postterm choriocarcinoma". J Reprod Med. 43 (1): 75–80. PMID 9475153.
- ↑ Zhang W, Liu B, Wu J, Sun B (April 2017). "Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series". J Med Case Rep. 11 (1): 110. doi:10.1186/s13256-017-1256-9. PMID 28411623.