Gestational trophoblastic neoplasia causes: Difference between revisions
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==Overview== | ==Overview== | ||
Complete hydatidiform mole arises when an ovum without maternal chromosomes is fertilized by one sperm which duplicates its DNA, resulting in a 46XX androgenetic karyotype. Partial hydatidiform moles are almost always triploid, resulting from the fertilization of a healthy ovum by two sperms. Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma. Gestational type choriocarcinoma arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion. Non-gestational type choriocarcinoma | [[Hydatidiform mole|Complete hydatidiform mole]] arises when an [[ovum]] without maternal [[Chromosome|chromosomes]] is [[Fertilization|fertilized]] by one [[sperm]] which duplicates its [[DNA]], resulting in a 46XX androgenetic [[karyotype]]. [[Hydatidiform mole|Partial hydatidiform moles]] are almost always [[Polyploidy|triploid]], resulting from the [[fertilization]] of a healthy [[ovum]] by two [[Sperm|sperms]]. Abnormal [[Trophoblast|trophoblastic]] population undergoing [[hyperplasia]] and [[anaplasia]] can give rise to choriocarcinoma. [[Gestation|Gestational]] type choriocarcinoma arises following a [[hydatidiform mole]], normal [[pregnancy]], or most commonly, abortion. Non-[[Gestation|gestational]] type choriocarcinoma arises from [[Pluripotency|pluripotent]] [[Germ cell|germ cells]]. [[Placenta|Placental]]-site [[Trophoblast|trophoblastic]] [[tumor]] (PSTT) arises from the [[Placenta|placental]] implantation site when the [[Trophoblast|trophoblastic]] [[Cell (biology)|cells]] infiltrate the [[myometrium]]. [[Epithelioid]] [[Trophoblast|trophoblastic]] [[tumor]] (ETT) arises from the intermediate [[Trophoblast|trophoblastic]] [[Cell (biology)|cells]] of [[chorion]] laeve. | ||
==Causes== | ==Causes== | ||
The causality of gestational trophoblastic neoplasia based on the | The causality of gestational trophoblastic neoplasia based on the sub-types is as follows: | ||
''' | '''Invasive mole''' | ||
* | *It arises from [[Myometrium|myometrial]] invasion of [[hydatidiform mole]] via direct extension through [[Tissue (biology)|tissue]] or [[Vein|venous]] channels. | ||
*Approximately 15~20% of [[Hydatidiform mole|complete hydatidiform moles (CHMs)]] and less than 1~5% of [[Hydatidiform mole|partial hydatidiform moles (PHMs)]] can undergo [[malignant transformation]] into an invasive mole.<ref name="pmid17679081">{{cite journal |vauthors=El-Helw LM, Hancock BW |title=Treatment of metastatic gestational trophoblastic neoplasia |journal=Lancet Oncol. |volume=8 |issue=8 |pages=715–24 |date=August 2007 |pmid=17679081 |doi=10.1016/S1470-2045(07)70239-5 |url=}}</ref><ref name="pmid20673583">{{cite journal |vauthors=Seckl MJ, Sebire NJ, Berkowitz RS |title=Gestational trophoblastic disease |journal=Lancet |volume=376 |issue=9742 |pages=717–29 |date=August 2010 |pmid=20673583 |doi=10.1016/S0140-6736(10)60280-2 |url=}}</ref><ref name="pmid17613426">{{cite journal |vauthors=Shih IeM |title=Gestational trophoblastic neoplasia--pathogenesis and potential therapeutic targets |journal=Lancet Oncol. |volume=8 |issue=7 |pages=642–50 |date=July 2007 |pmid=17613426 |doi=10.1016/S1470-2045(07)70204-8 |url=}}</ref> | |||
*In rare instances, invasive mole can arise from [[Iatrogenesis|iatrogenic]] [[Uterus|uterine]] [[perforation]].<ref name="ShenWan2017">{{cite journal|last1=Shen|first1=Yuanming|last2=Wan|first2=Xiaoyun|last3=Xie|first3=Xing|title=A metastatic invasive mole arising from iatrogenic uterus perforation|journal=BMC Cancer|volume=17|issue=1|year=2017|issn=1471-2407|doi=10.1186/s12885-017-3904-2}}</ref> | |||
'''Choriocarcinoma''' | '''Choriocarcinoma''' | ||
*Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma.<ref name="pmid20728069">{{cite journal |vauthors=Lurain JR |title=Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole |journal=Am. J. Obstet. Gynecol. |volume=203 |issue=6 |pages=531–9 |date=December 2010 |pmid=20728069 |doi=10.1016/j.ajog.2010.06.073 |url=}}</ref> | *Abnormal [[Trophoblast|trophoblastic]] population undergoing [[hyperplasia]] and [[anaplasia]] can give rise to [[choriocarcinoma]].<ref name="pmid20728069">{{cite journal |vauthors=Lurain JR |title=Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole |journal=Am. J. Obstet. Gynecol. |volume=203 |issue=6 |pages=531–9 |date=December 2010 |pmid=20728069 |doi=10.1016/j.ajog.2010.06.073 |url=}}</ref> | ||
*Gestational type arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion.<ref name="pmid29681814">{{cite journal |vauthors=Stockton L, Green E, Kaur B, De Winton E |title=Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature |journal=Case Rep Oncol |volume=11 |issue=1 |pages=151–158 |date=2018 |pmid=29681814 |pmc=5903105 |doi=10.1159/000486639 |url=}}</ref> | *[[Gestation|Gestational]] type arises following a [[hydatidiform mole]], normal [[pregnancy]], or most commonly, abortion.<ref name="pmid29681814">{{cite journal |vauthors=Stockton L, Green E, Kaur B, De Winton E |title=Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature |journal=Case Rep Oncol |volume=11 |issue=1 |pages=151–158 |date=2018 |pmid=29681814 |pmc=5903105 |doi=10.1159/000486639 |url=}}</ref> | ||
*Non-gestational type arises from pluripotent germ cells.<ref name="pmid29681814">{{cite journal |vauthors=Stockton L, Green E, Kaur B, De Winton E |title=Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature |journal=Case Rep Oncol |volume=11 |issue=1 |pages=151–158 |date=2018 |pmid=29681814 |pmc=5903105 |doi=10.1159/000486639 |url=}}</ref> | *Non-[[Gestation|gestational]] type arises from [[Pluripotency|pluripotent]] [[Germ cell|germ cells]].<ref name="pmid29681814">{{cite journal |vauthors=Stockton L, Green E, Kaur B, De Winton E |title=Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature |journal=Case Rep Oncol |volume=11 |issue=1 |pages=151–158 |date=2018 |pmid=29681814 |pmc=5903105 |doi=10.1159/000486639 |url=}}</ref> | ||
'''Placental-site Trophoblastic Tumor (PSTT)''' | '''Placental-site Trophoblastic Tumor (PSTT)''' | ||
*It arises from the placental implantation site when the trophoblastic cells infiltrate the myometrium.<ref>https://www.cancer.gov/types/gestational-trophoblastic</ref> | *It arises from the [[Placenta|placental]] implantation site when the [[Trophoblast|trophoblastic]] [[Cell (biology)|cells]] infiltrate the [[myometrium]].<ref>https://www.cancer.gov/types/gestational-trophoblastic</ref> | ||
'''Epithelioid Trophoblastic Tumor (ETT)''' | '''Epithelioid Trophoblastic Tumor (ETT)''' | ||
*It arises from the intermediate trophoblastic cells of chorion laeve.<ref name="pmid28174805">{{cite journal |vauthors=Stănculescu RV, Bauşic V, Vlădescu TC, Vasilescu F, Brătilă E |title=Epithelioid trophoblastic tumor: a case report and literature review |journal=Rom J Morphol Embryol |volume=57 |issue=4 |pages=1365–1370 |date=2016 |pmid=28174805 |doi= |url=}}</ref> | *It arises from the intermediate [[Trophoblast|trophoblastic]] [[Cell (biology)|cells]] of [[chorion]] laeve.<ref name="pmid28174805">{{cite journal |vauthors=Stănculescu RV, Bauşic V, Vlădescu TC, Vasilescu F, Brătilă E |title=Epithelioid trophoblastic tumor: a case report and literature review |journal=Rom J Morphol Embryol |volume=57 |issue=4 |pages=1365–1370 |date=2016 |pmid=28174805 |doi= |url=}}</ref> | ||
==References== | ==References== | ||
Latest revision as of 23:55, 2 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
Complete hydatidiform mole arises when an ovum without maternal chromosomes is fertilized by one sperm which duplicates its DNA, resulting in a 46XX androgenetic karyotype. Partial hydatidiform moles are almost always triploid, resulting from the fertilization of a healthy ovum by two sperms. Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma. Gestational type choriocarcinoma arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion. Non-gestational type choriocarcinoma arises from pluripotent germ cells. Placental-site trophoblastic tumor (PSTT) arises from the placental implantation site when the trophoblastic cells infiltrate the myometrium. Epithelioid trophoblastic tumor (ETT) arises from the intermediate trophoblastic cells of chorion laeve.
Causes
The causality of gestational trophoblastic neoplasia based on the sub-types is as follows:
Invasive mole
- It arises from myometrial invasion of hydatidiform mole via direct extension through tissue or venous channels.
- Approximately 15~20% of complete hydatidiform moles (CHMs) and less than 1~5% of partial hydatidiform moles (PHMs) can undergo malignant transformation into an invasive mole.[1][2][3]
- In rare instances, invasive mole can arise from iatrogenic uterine perforation.[4]
Choriocarcinoma
- Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma.[5]
- Gestational type arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion.[6]
- Non-gestational type arises from pluripotent germ cells.[6]
Placental-site Trophoblastic Tumor (PSTT)
- It arises from the placental implantation site when the trophoblastic cells infiltrate the myometrium.[7]
Epithelioid Trophoblastic Tumor (ETT)
- It arises from the intermediate trophoblastic cells of chorion laeve.[8]
References
- ↑ El-Helw LM, Hancock BW (August 2007). "Treatment of metastatic gestational trophoblastic neoplasia". Lancet Oncol. 8 (8): 715–24. doi:10.1016/S1470-2045(07)70239-5. PMID 17679081.
- ↑ Seckl MJ, Sebire NJ, Berkowitz RS (August 2010). "Gestational trophoblastic disease". Lancet. 376 (9742): 717–29. doi:10.1016/S0140-6736(10)60280-2. PMID 20673583.
- ↑ Shih I (July 2007). "Gestational trophoblastic neoplasia--pathogenesis and potential therapeutic targets". Lancet Oncol. 8 (7): 642–50. doi:10.1016/S1470-2045(07)70204-8. PMID 17613426. Vancouver style error: initials (help)
- ↑ Shen, Yuanming; Wan, Xiaoyun; Xie, Xing (2017). "A metastatic invasive mole arising from iatrogenic uterus perforation". BMC Cancer. 17 (1). doi:10.1186/s12885-017-3904-2. ISSN 1471-2407.
- ↑ Lurain JR (December 2010). "Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole". Am. J. Obstet. Gynecol. 203 (6): 531–9. doi:10.1016/j.ajog.2010.06.073. PMID 20728069.
- ↑ 6.0 6.1 Stockton L, Green E, Kaur B, De Winton E (2018). "Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature". Case Rep Oncol. 11 (1): 151–158. doi:10.1159/000486639. PMC 5903105. PMID 29681814.
- ↑ https://www.cancer.gov/types/gestational-trophoblastic
- ↑ Stănculescu RV, Bauşic V, Vlădescu TC, Vasilescu F, Brătilă E (2016). "Epithelioid trophoblastic tumor: a case report and literature review". Rom J Morphol Embryol. 57 (4): 1365–1370. PMID 28174805.