Gestational trophoblastic neoplasia natural history, complications and prognosis

Gestational trophoblastic neoplasia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.

Natural history

• Patient has early symptoms such as vaginal bleeding, passing of tissue resembling a “bunch of grapes” from the vagina, the abdomen may grow at a much faster rate than with a normal pregnancy
• Nausea and vomiting, and absent fetal movement during pregnancy.
• As the tumor grows larger, patient may notice symptoms like lump in the vagina, hemoptysis, chest pain, trouble breathing, headache, dizziness, jaundice, paralysis, seizure, dysarthria, and dysphasia.

Prognosis

• The prognosis for cure of patients with GTDs is good even when the disease has spread to distant organs, especially when only the lungs are involved.
• The probability of cure depends on the following:

• Histologic type (invasive mole or choriocarcinoma)
• Extent of spread of the disease/largest tumor size
• Level of serum beta-hCG
• Duration of disease from the initial pregnancy event to start of treatment
• Number and specific sites of metastasis
• Nature of antecedent pregnancy
• Extent of prior treatment

Complications

Gestational trophoblastic neoplasia maybe associated with the following complications:

• Metastasis

• Recurrent pregnancy loss
• Hemoptysis
• Pneumothorax
• Anemia
• Hyperthyroidism
• Pre-eclampsia