Gestational Trophoblastic Neoplasia: what it is and how to treat it

Understanding the symptoms, causes, and treatment options for this unusual pregnancy condition

Gestational trophoblastic neoplasia (GTN) represents a group of rare but significant diseases that develop during pregnancy. These conditions arise from cells that would normally form the placenta, ranging from benign to highly treatable malignancies. Understanding this disease is crucial for early diagnosis and effective treatment.

Types and Diagnosis

Gestational trophoblastic neoplasia is classified into various forms, including complete or partial hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor (ETT). Diagnosis of these conditions often involves ultrasound and human chorionic gonadotropin (hCG) testing, with ultrasound revealing distinctive signs such as the “snowstorm sign” for complete mole. However, definitive diagnosis may require histological examination.

Symptoms and Risk Factors

Symptoms of gestational trophoblastic neoplasia can vary but often include abnormal vaginal bleeding, a uterus size larger than expected for the pregnancy date, and in some cases, signs of an overactive thyroid. Risk factors include maternal age (under 20 or over 35 years), a previous molar pregnancy, and a history of miscarriages.

Treatment Options

Treatment options for gestational trophoblastic neoplasia vary depending on the type and stage of the disease and may include dilation and curettage (D&C), chemotherapy, radiation therapy, and in some cases, hysterectomy. Treatment choice also depends on the patient’s overall health, medical history, and desire to preserve fertility. Fortunately, cure rates for GTN are close to 100% when the disease is diagnosed and treated appropriately.

Despite its rarity, gestational trophoblastic neoplasia is a condition that can have a significant impact on pregnant women and their families. Awareness of symptoms, understanding of risk factors, and knowledge of treatment options are essential for addressing this disease. With timely diagnosis and appropriate treatment, most women can expect a positive outcome.


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