Obstetrics and Gynecology
Fariba Yarandi; Sara Ramhormozian; Behzad Asanjarani; Elham Shirali
Volume 7, Issue 5 , July and August 2022, , Pages 458-462
Abstract
GTN (Gestational trophoblastic neoplasm) complications such as uterine rupture or massive bleeding can be life-threatening and usually need a hysterectomy. In young patients who want to preserve fertility, hysterectomy is not suitable. Under specific circumstances, some physicians choose conservative ...
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GTN (Gestational trophoblastic neoplasm) complications such as uterine rupture or massive bleeding can be life-threatening and usually need a hysterectomy. In young patients who want to preserve fertility, hysterectomy is not suitable. Under specific circumstances, some physicians choose conservative management. Uterine preservation after complicated GTN is rare by itself. In conclusion, conservative management of GTN patients who develop high-risk complications and desire for future pregnancies must be considered an option. In published case reports, outcomes of conservative surgical management have been very good if managed properly.
Soheila Aminimoghaddam; Nastaran Abolghasem; Tahereh Ashraf- Ganjooie
Volume 3, Issue 3 , September and October 2018, , Pages 123-128
Abstract
Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients ...
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Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.
