Gestational Trophoblastic Disease (GTD)
Gestational trophoblastic disease (GTD) is a disease of the uterus in which trophoblast cells, which the body uses to implant an embryo and form the placenta, grow abnormally and turn cancerous. GTD is thus distinguished from other uterine cancers, which are primarily sarcomas. When a GTD tumor becomes malignant, it is referred to as a choriocarcinoma. Choriocarcinomas usually occur during or after pregnancy, and are also referred to as gestational choriocarcinomas. (Non-gestational choriocarcinoma, which arises without a preceding pregnancy, does sometimes occur, but is much rarer.) There are several forms of gestational trophoblastic disease (GTD).
Types of Gestational Trophoblastic Disease (GTD)
Hydatidiform Mole / Molar Pregnancy
The most common form of GTD, this is generally diagnosed early in pregnancy. A complete mole is a fertilized egg with no maternal DNA; a complete mole will not develop into a fetus. A partial mole is an egg fertilized by two sperm, leading to abnormal fetal development and a non-viable pregnancy.
Invasive Mole
This is a mole that grows into the muscle of the uterus.
Gestational Choriocarcinoma
This is a malignant tumor that can spread to other cells. Gestational choriocarcinoma can occur both during and after pregnancy, including in a molar pregnancy.
Placental Site Trophoblastic Tumor (PSTT)
This is a very rare, slow-growing tumor that occurs years after a molar pregnancy, non-molar abortion, or term pregnancy. It usually presents gynecologic symptoms, rarely with hyperprolactinaemia or nephrotic syndrome, and is usually treated with a hysterectomy.
Epithelioid Trophoblastic Tumor (ETT)
This is a type of GTD of the intermediate trophoblast cells, characterized by a long interval following the pregnancy, less aggressive than a choriocarcinoma, and with a similar metastatic potential to PSTT.
Gestational Trophoblastic Disease Symptoms
- Vaginal bleeding occurring in early pregnancy
- Rapid uterine growth
- Severe nausea and vomiting
- Elevated levels of human chorionic gonadotropin (hCG) hormone
Gestational Trophoblastic Disease Causes and Risk Factors
- Pregnancy under 15 years old or over 45 years old
- Previous molar pregnancy
- Higher incidence among Asian women
Gestational Trophoblastic Disease Diagnosis
Diagnosis of a gestational trophoblastic disease typically involves an ultrasound to detect abnormal placental tissue, hCG blood tests to monitor hormone levels, and an examination to distinguish between partial and complete moles.
Gestational Trophoblastic Disease Treatment
Treatment of GTD is dependent on both the type of GTD and the patient's health. Surgery to remove irregular tissues and cells is usually the first step, with dilation and curettage (D&C) being the most common. Treatment also typically includes some combination of chemotherapy, radiation, and/or a hysterectomy.
Gestational Trophoblastic Disease Prognosis
GTD has a good prognosis and is curable in most cases, especially when detected early. Chemotherapy for molar pregnancy and other gestational trophoblastic diseases offers a high cure rate. Regular monitoring of hCG will alert patients and providers of reoccurrence.
Why Choose UsTrusted Providers of Gynecologic Oncology in the Phoenix, AZ Metro Area
Women's Cancer Institute of Arizona offers top quality gynecologic oncology treatments in the metro Phoenix area. Our gynecologic oncology specialists are well versed in all forms of gestational trophoblastic disease (GTD), and can ensure the best outcome for your cancer care.