Gestational Trophoblastic Disease Flashcards Preview

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Flashcards in Gestational Trophoblastic Disease Deck (53)
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1

What is gestational trophoblastic disease?

A term used to describe a group of pregnancy related tumours

2

What can gestational trophoblastic disease be divided into?

- Pre-malignant conditions
- Malignant conditions

3

What form of gestational trophoblastic disease is more common?

Pre-malignant conditions

4

What are the types of pre-malignant gestational trophoblastic disease?

- Partial molar pregnancy
- Complete molar pregnancy

5

What are the types of malignant gestational trophoblastic disease?

- Invasive mole
- Choriocarcinoma
- Placental trophoblastic site tumour
- Epithelioid trophoblastic tumour

6

What is the fetus formed from in normal conception, in terms of chromosomes?

23 maternal chromosomes and 23 paternal chromosomes

7

When does a molar pregnancy arise?

When there is an abnormality in chromosomal number during fertilisation

8

What is a partial molar pregnancy?

When one ovum with 23 chromosomes is fertilized by 2 sperm, each with 23 chromosomes, producing cells with 69 chromosomes

9

Can a partial molar pregnancy exist with a viable fetus?

Yes

10

What happens chromosomally in a viable partial molar pregnancy?

Mosaicism where the fetus has normal karyotype and triploidy is confined to the placenta
(Normally the fetus and placenta are triploidy, which isn't viable)

11

What is a complete molar pregnancy?

Where one ovum without any chromosomes is fertilised by one sperm which duplicates, or less commonly by two different sperm, leading to 46 chromosomes of paternal origin alone

12

Are molar pregnancies benign or malignant?

Usually benign, but can become malignant

13

What happens when molar pregnancies become malignant?

They invade into the myometrium and disseminate throughout the body

14

What are malignant molar pregnancies known as?

Invasive moles

15

What is a choriocarcinoma?

A malignancy of trophoblastic cells of the placenta

16

What does choriocarcinoma commonly co-exist with?

Molar pregnancy

17

Where does choriocarcinoma characterically metastasise to?

Lungs

18

What is a placental site trophoblastic tumour?

A malignancy of the intermediate trophoblasts

19

What are the intermediate trophoblasts normally responsible for?

Anchoring the placenta to the uterus

20

What can placental site trophoblastic tumours occur after?

- Normal pregnancy (more common)
- Molar pregnancy
- Miscarriage

21

What is an epithelioid trophoblastic tumour?

A malignancy of the trophoblastic placental cells

22

What can an epithelioid trophoblastic tumour be difficult to determine from?

Choriocarcinoma

23

What does an epithelioid trophoblastic tumour mimic the cytological features of?

A squamous cell carcinoma

24

What are the risk factors for gestational trophoblastic disease?

- Maternal age <20 or >35
- Previous gestational trophoblastic disease
- Previous miscarriage
- Use of OCP

25

How do molar pregnancies most commonly present?

Vaginal bleeding and abdominal pain early in pregnancy

26

What is found on examination in molar pregnancy?

Uterus can be larger than expected for gestation, and of soft, boggy consistency

27

What finding can occasionally be present in molar pregnancy?

Molar vesicles shed per vagina

28

How is the diagnosis of molar pregnancy usually made?

Ultrasound

29

What are the later symptoms may be present if molar pregnancy is missed?

- Hyperemesis
- Hyperthyroidism
- Anaemia

30

What are the most common investigations in the assessment of suspected GTD?

- ß-hCG
- Ultrasound scan
- Histological examination of products of conception