Role of Hysterectomy in the Management of Gestational Trophoblastic Neoplasia: Review Citing Three Interesting Cases

Persistent Invasive Mole: A Case Report

“…18 Histopathologic examination of D&C sample showed villi and trophoblastic tissue which is similar to a study by Barber et al 19 In our study, patient was presented with vaginal bleeding with marked elevations in serum β-hCG levels which is complimentary to a study by Shaaban et al 20 Diagnosis include urine and blood levels of hCG (which are elevated during pregnancy) may give good indication, in most of the cases the levels are elevated, ultrasound (which shows a heterogeneous mass with no fetal development and theca-lutein ovarian cysts) and imaging tests (x-rays, magnetic fields, or radioactive substances) that help find out whether a tumor is present and to learn how far it may have spread. 2,3 Diagnosis is made based on measurement of serum β-hCG levels and USG findings as in a study conducted by Akhavan et al and Shaaban et al 20,21 In this case, GTD diagnosis as made primarily based on elevated serum β-hCG and pathologic examination confirmed our findings. The staging of the disease and a score is allotted to the patients by assessing the risk factors based on the FIGO anatomical staging and WHO prognostic Scoring System (Table 1).…”

“…1 It is a disease of women in reproductive age with several forms of manifestations ranging from pre-malignant lesions which includes hydatidiform mole (partial and complete mole) to malignant lesions (gestational trophoblastic neoplasm) comprising invasive mole, choriocarcinoma and placental site trophoblastic tumor (PSTT). 2,3 Human Chorionic Gonadotropin (hCG) is produced by this neoplasm and acts as sensitive tumor marker that is in consonance with clinical outcome of all GTD types except PSTT. 4 Risk factors associated with developing GTD include maternal age (> 40 and < 20 years), history of prior molar pregnancy or miscarriage, ectopic pregnancy, multiparity, endogenous oestrogens, high beta carotene diet, high animal fat diet, ethnicity, A and AB blood groups, use of oral contraceptives, environmental toxins, smoking, alcohol consumption and herbicide exposure.…”

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“…Hal ini sesuai dengan penelitian oleh Azam Sadat Mousavi dkk didapatkan bahwa terdapat hubungan yang kuat pada pasien TTG yang dilakukan operasi dengan penurunan kadar β-hCG setelah 1 minggu dan 2 minggu pascaevakuasi. 16 Pada pasien koriokarsinoma yang dilakukan operasi 74,07% tidak memiliki metastasis. Namun, 14,81% metastasis terdapat pada paru-paru.…”