RT Book, Section
A1 Lurain, John R.
A2 Boyiadzis, Michael M.
A2 Fojo, Tito
SR Print(0)
ID 1187881952
T1 Gestational Trophoblastic Neoplasia
T2 Hematology-Oncology Therapy, 3e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260117400
LK hemonc.mhmedical.com/content.aspx?aid=1187881952
RD 2024/04/19
AB EpidemiologyGestational  trophoblastic  disease  (GTD)  is  a  spectrum  of  inter-related  abnormal  proliferations  of  the  placental  trophoblast,  encompassing  benign  hydatidiform  mole  (complete  and  partial)  as  well  as  malignant  gestational  trophoblastic  neoplasia  (GTN),  which  includes  invasive  mole  (IM),  choriocarcinoma  (CC),  placental  site  trophoblastic  tumor  (PSTT),  and  epithelioid  trophoblastic  tumor  (ETT)Complete  Hydatidiform  Mole  (CHM)Incidence:  1  in  1000–2000  pregnancies  in  the  United  States  and  Europe,  but  higher  in  Asia  and  Latin  AmericaRisk  Factors:  extremes  of  reproductive  age  (40),  prior  molar  pregnancyGTN:  develops  in  about  15–20%  (12–18%  IM  and  2–3%  CC)  after  molar  evacuationPartial  Hydatidiform  Mole  (PHM)Incidence:  3  in  1000  pregnanciesRisk  Factors:  possible  history  of  irregular  menses  and  prolonged  oral  contraceptive  useGTN:  develops  in  1–5%  after  molar  evacuation  (almost  all  IM)ChoriocarcinomaIncidence:  1  in  40,000  pregnanciesRisk  Factors:  history  of  complete  hydatidiform  mole  (1000×  more  likely  to  arise  from  a  CHM,  although  one-half  of  cases  develop  from  other  pregnancy  events)Common  sites  of  metastasis:  lungs  (80%),  brain  (10%),  liver  (10%),  vagina  (~5%)PSTT/ETTIncidence:  <0.2%  of  all  cases  of  GTDRisk  Factors:  insufficient  data  exist  to  adequately  characterize  any  risk  factors;  however,  95%  develop  following  a  term  pregnancy  or  nonmolar  abortion  and  may  present  many  months  or  years  later  Lurain  JR.  Am  J  Obstet  Gynecol  2010;203:531–539