Worldwide Controversies in Gestational Trophoblastic Neoplasms

Abstract

This article reviews worldwide controversies concerning gestational trophoblastic neoplasms (hydatidiform mole, invasive mole, and choriocarcinoma). The epidemiology, endocrinology, histopathologic grading, classification, diagnosis, treatment, management and follow-up (including chemotherapy, irradiation, and immunotherapy) of gestational trophoblastic neoplasms - particularly molar pregnancies - are discussed; and ways to help create a standardized classification system and provide optimal treatment for each type of patient are suggested.

A clinico-pathological study of complete and partial hydatidiform moles in a Nigerian population

“…The relative incidence of CHM and PHM depends on source of specimen, clinical cases or histological samples. Partial mole, although a relatively common phenomenon, is much under diagnosed both clinically and pathologically (Goldstein, 1977;Jeffere et al, 1993). In comparative studies by Jacobs et al (1982) in Hawaii, they observed a several-fold increase in the number of diagnosed PHM in a prospective study when compared with the gures from a retrospective study that depended on clinical and pathological data alone.…”

Relationship of Histopathological Representation of Excessive Proliferation of Trophoblast Cells with the Possibility of Malignant Events After Complete Hydatidiform Mole

“…15,16 At Dr. Cipto Mangunkusumo Hospital in Jakarta, Indonesia, the ratio is quite high (1 in 77 pregnancies) especially for young women and old women, and approximately 15-20% experience malignancy in becoming gestational trophoblastic tumor, while the factors that cause changes in hydatidiform mole to gestational trophoblastic tumor are still under study. 1,3,4 The Bracken MB study proclaimed that maternal age affects molar pregnancies. Women over 40 years of age have 5-10 times greater risks of suffering from complete hydatidiform mole.…”

“…Still, approximately 15–20% will undergo a malignant transformation into gestational trophoblastic tumor (GTT). 1 , 3 , 4 The risk factors that are thought to play a role in the occurrence of malignancy after hydatidiform mole are not known yet. Several epidemiological studies report that the risk of choriocarcinoma increases with age.…”

Enfermedad trofoblástica gestacional diagnóstico, tratamiento y seguimiento

“…La quimioterapia se administró de acuerdo con lo informado en la literatura (3, 5, 7, 8, 9, 34 y 36), como se señaló en material y métodos. Cuando se utiliza el MTX sólo o en quimioterapia múltiple, se trataba de utilizar con factor de rescate, ya que según Goldstein (37,38), de esta manera se reduce su t oxicidad sin disminuir su efectividad, además de que en dosis altas alcanza los niveles adecuados en cerebro en casos de compromiso cerebral.…”