Gestational trophoblastic dis... Health Article

Definition

Gestational trophoblastic disease is a quick growing form of cancer that occurs in a woman's uterus after a pregnancy, miscarriage, or abortion. It is usually metastatic, which means it spreads to other places in the body.

Gestational trophoblastic disease is also called a choriocarcinoma.

Alternative Names

Chorioblastoma; Choriocarcinoma; Trophoblastic tumor; Chorioepithelioma; Invasive/malignant mole; Gestational trophoblastic neoplasia

Causes, incidence, and risk factors

Choriocarcinoma remains an uncommon, yet almost always curable, cancer that can be associated with pregnancy.

The cancer forms in the tissues that develop after a baby is conceived. A choriocarcinoma looks like the cells that normally surround a developing baby (embryo).

In approximately 50% of cases of choriocarcinoma, the woman had a hydatidiform mole (molar pregnancy).

Nearly one-fourth of choriocarcinomas occur after pregnancy has resulted in the delivery of a normal child. The remainder of cases occurs after any type of abortion, ectopic pregnancy, or genital tumor.

Symptoms

A possible symptom is continued vaginal bleeding in a woman with a recent history of hydatidiform mole, abortion, or pregnancy.

Additional symptoms may include:

• Irregular vaginal bleeding
• Certain types of cysts on the ovaries
• Uneven swelling of the uterus
• Persistently high HCG (pregnancy hormone) levels (positive pregnancy test)
• Pain

Signs and tests

A pelvic examination may reveal continued uterine enlargement or a tumor. These conditions may be felt within the genito-urinary tract.

Tests include:

• Quantitative serum HCG (blood test to confirm pregnancy)
• CT scan
• Chest x-ray

These signs and tests apply to women with a recent history of hydatidiform mole, abortion, or pregnancy.

Treatment

After an initial diagnosis, a careful history and examination are done to rule out metastasis (spread to other organs). Chemotherapy is the treatment of choice.

A hysterectomy is rarely required.

Support Groups

For additional information, see cancer resources.