Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide

World Journal of Clinical Oncology
A BragaMichael J Seckl

Abstract

Gestational trophoblastic neoplasia (GTN) is a rare tumor that originates from pregnancy that includes invasive mole, choriocarcinoma (CCA), placental site trophoblastic tumor and epithelioid trophoblastic tumor (PSTT/ETT). GTN presents different degrees of proliferation, invasion and dissemination, but, if treated in reference centers, has high cure rates, even in multi-metastatic cases. The diagnosis of GTN following a hydatidiform molar pregnancy is made according to the International Federation of Gynecology and Obstetrics (FIGO) 2000 criteria: four or more plateaued human chorionic gonadotropin (hCG) concentrations over three weeks; rise in hCG for three consecutive weekly measurements over at least a period of 2 weeks or more; and an elevated but falling hCG concentrations six or more months after molar evacuation. However, the latter reason for treatment is no longer used by many centers. In addition, GTN is diagnosed with a pathological diagnosis of CCA or PSTT/ETT. For staging after a molar pregnancy, FIGO recommends pelvic-transvaginal Doppler ultrasound and chest X-ray. In cases of pulmonary metastases with more than 1 cm, the screening should be complemented with chest computed tomography and brain magnetic resonanc...Continue Reading

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Citations

Jun 9, 2020·Journal of Family Medicine and Primary Care·Seyedeh Reyhaneh Yousefi Sharami, Elham Saffarieh
Oct 12, 2020·BMJ Case Reports·Mariana M ChavesVera Furtado Veiga
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Jun 20, 2021·The Indian Journal of Medical Research·Seema SinghalNeerja Bhatla

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Methods Mentioned

BETA
hysterectomy
biopsies
biopsy
X-ray
contraception

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