Management Options of Gestational Trophoblastic Disease

The “hook effect” causing a negative pregnancy test in a patient with an advanced molar pregnancy

“…The other classic clinical signs and symptoms, such as uterine enlargement greater than expected for gestation dates, hyperemesis, and medical complications, such as pregnancy induced hypertension, clinical hyperthyroidism and respiratory insufficiency, occur less frequently in recent years. This has been a result of earlier diagnosis from increased availability of ultrasonography and accurate tests for measurement of human chorionic gonadotropin (hCG) ( Lurain, 2010 , Berkowitz et al, 2014 , Soto-Wright et al, 1995 ).…”

“…Molar pregnancies are more commonly associated with markedly elevated hCG levels, with approximately 50% of patients having hCG levels > 100,000 mIU/mL ( Lurain, 2010 , Berkowitz et al, 2014 ). At serum levels of hCG above 500,000 mIU/mL, a “hook effect” can occur, resulting in an artificially low or negative value when using the current commercially available immunometric hCG assays ( Yeung and Cheung, 2014 , Mori and Lurain, 2015 ).…”

Epidemiology of Gestational Trophoblastic Disease at a Tertiary Hospital in India over Last 8 Years

“…About 24.35% developed GTN, 92.7% being stage I low risk. MTX was the single agent chemotherapy given in 88.74% with a remission rate of 96.26% (129/134) 3 ( Table 1).…”

“…. 3 Hysterectomy has a role in selected patients, including those with the drug-resistant disease, complications of the disease such as bleeding and as primary treatment in selected few. 4…”

Presentation of Placental Site Trophoblastic Tumor with Amenorrhea

“…Placental site throphoblastic tumor (PSTT) is an extremely rare form of the gestational throphoblastic disease (GTD) of which approximately 200 cases has been reported in the literature. [ 1 ] Histopathologically, PSTT is characterized by a neoplastic population of intermediate trophoblastic cells at the implantation site often arranged as sheets of polyhedral, round, or occasionally spindle-shaped cells that infiltrate the myometrium extensively. [ 2 3 ] Because of the rarity of this type of tumor, there is little information about its epidemiology and etiology and few large series on diagnosis and treatment have been published.…”