Gestational Trophoblastic Disease

Gestational Trophoblastic Disease

What is it?

Gestational trophoblastic disease (GTD) is a rare group of tumors that involves abnormal cell growth in theuterus of women of childbearing age. The tumors develop from cells that would normally grow into the placenta during a pregnancy. GTDs include hydatidiform mole (or molar pregnancy), choriocarcinoma and placental site trophoblastic tumors. Most GTDs are non-cancerous, although some develop into cancer. All are highly treatable.

What are the signs and symptoms?

  • Abnormal ultrasound
  • Elevated human chorionic gonadotropin (HCG) levels detected by a blood test
  • Missed menstrual period with elevated HCG
  • Abnormal bleeding

How is it diagnosed?

Dilation and curettage, also known as a “D and C.” (Dilation means to widen the opening of the cervix. Curettage involves removing a sample of the endometrium to be examinedby a pathologist .)
Tissue removed from the uterus is sent to the pathology lab for analysis.
Referral to a gynecologic oncologist for consultation is indicated if additional therapy is needed.

How is it treated?

After the removal of the abnormal GTD tissue, some cases resolve spontaneously. After the removal of the abnormal tissue, serial measurements of HCG are obtained or monitored until it returns to normal values. If the HCG level remains elevated, additional treatment is needed.

  • Surgery
    • A suction dilation and curettage usually removes all abnormal tissue and preserves the patients’ fertility
    • A hysterectomy (removal of the uterus) may be performed if a woman has GTD and is absolutely sure she does not want any more children
  • Chemotherapy
    • If a woman’s HCG levels fail to decrease after a procedure, additional treatment is recommended. GTD is extremely sensitive to anti-cancer drugs.
    • Methotrexate
    • Chemotherapy

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