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Gestational Trophoblastic Neoplasm

GTN


Presentation

  • We reported two cases of metastatic gestational trophoblastic neoplasms with bizarre pulmonary symptoms, one patient with small bowel metastasis, and two patients with brain metastasis presenting with unusual manifestations.[ncbi.nlm.nih.gov]
  • Due to the characteristic of GTN, clinical manifestations can be varied like in the present patient who presented symptoms other than the typical symptoms of GTN, which can cause confusion in managing patients.[synapse.koreamed.org]
  • We present a case of a young woman who presented 30 days after evacuation of a molar pregnancy with invasive and metastatic GTN complicated by a uterine rupture and hemoperitoneum.[westjem.com]
Chills
  • She denied fever, chills, emesis, syncope, dyspnea, chest pain, or vaginal bleeding, and she had no urinary symptoms.[westjem.com]
Constipation
  • Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms. There are ways to manage constipation after your surgery.[oncolink.org]
  • […] medical history pertinent for deep vein thrombosis, ovarian cysts, and osteopenia presented to her internist with report of irregular uterine bleeding for the preceding three months, accompanied by complaints of abdominal bloating, night sweats, and constipation[cancerindex.org]
Right Flank Pain
  • After a week, she presented to the emergency department with a history of acute onset of severe right flank pain that started 3 hours ago. At that time of the visit, hemoglobin was 8.2 g/dL, and decreased to 5.1 g/dL within one hour.[synapse.koreamed.org]
Thrombosis
  • Deep venous thrombosis within 6 months, unless the patient is therapeutically anti-coagulated for at least 2 weeks.[clinicaltrials.gov]
  • CASE PRESENTATION: A 49-year-old Caucasian female with past medical history pertinent for deep vein thrombosis, ovarian cysts, and osteopenia presented to her internist with report of irregular uterine bleeding for the preceding three months, accompanied[cancerindex.org]
Fracture
  • In this situation, low molecular weight heparin is preferred Known active viral or nonviral hepatitis Pregnant or actively breastfeeding without intention to discontinue prior to initiation of study Open wounds or unhealed fractures within 28 days of[clinicaltrials.gov]
Skin Lesion
  • However, the incidence rates of myelosuppression (white blood cell decline), gastrointestinal reactions (nausea, vomiting, dental ulcer, and diarrhea), skin lesions and phlebitis were lower in the tegafur group than in the 5-Fu group (P 0.05).[ncbi.nlm.nih.gov]
Foul Smelling Vaginal Discharge
  • Clinical examination confirmed an abdominal uterine mass of 22 weeks’ gestation with a foul-smelling vaginal discharge.[sajhivmed.org.za]
Adnexal Tenderness
  • Her pelvic examination showed scant brown fluid in the vaginal vault with diffuse and significant uterine and adnexal tenderness to palpation. Laboratory testing demonstrated a quantitative serum HCG level of 14,552 mIU/mL.[westjem.com]

Workup

  • 1859 Infectious Agents and Cancer 549 1860 Cancer of the Skin 1863 Melanoma 1889 Diagnostic Studies and Pretreatment Staging 1001 1908 Principles of Isolation Perfusion 701 1923 Intraocular Melanomas 1951 Invasion and Metastasis 117 1952 Metastatic WorkUp[books.google.com]
  • For example, the section on noninvasive hydatidiform mole recommends the tests that should be routinely performed during workup, followed by surgery with either suction, dilation and curettage – preferably under ultrasound guidance – or hysterectomy for[mdedge.com]
  • Diagnostic workup includes complete bloodwork, HCG and CT chest/abdomen/pelvis /- CT or MR brain.[bccancer.bc.ca]
  • In borderline cases, the final diagnosis of invasion versus non-invasion is confirmed only by histopathology and hence all the evacuated moles need to undergo a complete pathological workup.[sonoworld.com]
  • For the evidence on work-up, search terms included: gestational trophoblastic neoplasia AND workup or chest x-ray or magnetic resonance imaging or computed tomography or pelvic ultrasound or complete blood count or beta hCG or liver function tests or[guidelinecentral.com]
Pericardial Effusion
  • Current treatment on another therapeutic clinical trial Uncontrolled chronic hypertension defined as systolic 150 or diastolic 90 despite optimal therapy Significant pericardial effusion, pleural effusion, or ascites Active bleeding or pathologic condition[clinicaltrials.gov]

Treatment

  • A patient with gestational trophoblastic neoplasm failed treatment with several standard chemotherapy regimens and had progressive disease with development of lung and brain metastases and a rising HCG level.[ncbi.nlm.nih.gov]
  • Jenny Ko 1140 Appropriate Follow Up After Treatment of GTN & Proceeding with Pregnancy - Dr. Trevor Cohen 1200 Lunch PART THREE: TREATMENT OF HIGH RISK DISEASE 1300 Multi-Agent Treatment for High Risk GTN - Dr.[ubccpd.ca]
  • Conclusions : Hysterectomy is a safe and effective treatment method, especially for GTNs which are resistant to conventional treatment. keywords: adjuvant hysterectomy; gestational trophoblastic neoplasia, surgical treatment references: Brewer JI, Eckman[termedia.pl]

Prognosis

  • Histologic grading or hydatidiform moles is relevant to their prognosis and biologic behavior.[ncbi.nlm.nih.gov]
  • Prognosis The overall recovery rate is around 99%. The prognosis is very closely related to the rapidity of diagnosis, the risk level of the tumor (low or high) and the suitability of treatment.[orpha.net]
  • Response to treatment for GTN is generally favourable; but the sequelae of HIV and/or AIDS, the resultant low CD4 counts, comorbidities, poor performance status and the extent of metastatic disease in patients receiving chemotherapy, compromise the prognosis[ajol.info]

Etiology

  • Etiology The etiology of gestational trophoblastic tumors is not known.[orpha.net]
  • Abstract Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, comprised of a hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, epithelioid trophoblastic tumour and placental site trophoblastic tumour.[signavitae.com]
  • In this new 8th edition an outstanding editorial team from world-renowned medical centers continues to hone the leading edge forged in previous editions, with timely information on biology, immunology, etiology, epidemiology, prevention, screening, pathology[books.google.ro]

Epidemiology

  • ., Epidemiology and pathology of hydatidiform mole in the General Hospital of Mexico, Amer . J . Obstet . Gynecol . 85: 856 (1963). Google Scholar 10. Yen, S. and MacMahon, B., Epidemiologic features of trophoblastic disease, Amer . J . Obstet .[link.springer.com]
  • Summary Epidemiology Exact annual incidence is not known but it is estimated to be about 1/1,000,000 women.[orpha.net]
  • Pregnancy in association with a newly diagnosed cancer: a population-based epidemiologic assessment. Int J Cancer 1984; 34: 229-35.[termedia.pl]
  • Palmer JR (1994) Advances in the epidemiology of gestational trophoblastic disease. J Reprod Med 39:155–162 PubMed Google Scholar 7.[oadoi.org]
Sex distribution
Age distribution

Pathophysiology

  • The exact role of NALP7 in the pathophysiology of molar pregnancies is unknown yet. NALP7 could have a role either in oogenesis or in the endometrium during trophoblast invasion and decidualization.[oadoi.org]
  • For patient information, click here Gestational trophoblastic neoplasia Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Gestational trophoblastic neoplasia from other Diseases[wikidoc.org]
  • There is known female gender predominance, highlighting the important roles for sex hormones in the pathophysiology and progression of this disease.[omicsonline.org]

Prevention

  • […] cyclophosphamide 11 Ribavirin With or Without Monoclonal Antibody Therapy in Treating Patients Who Develop RSV Pneumonia Following Peripheral Stem Cell Transplantation Completed NCT00014391 Phase 3 ribavirin 12 Itraconazole Compared With Fluconazole to Prevent[malacards.org]
  • Your medical team will discuss with you the medications you will be taking, such as those for pain, blood clot, infection, constipation prevention and/or other conditions.[oncolink.org]
  • Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Gestational trophoblastic neoplasia On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images[wikidoc.org]
  • Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. ‎ Página 356 - Guidelines for Perinatal Care is required reading for all physicians and nurses who care for pregnant women and newborns.[books.google.es]
  • With increased attention, perhaps someday we’ll find a reason for molar pregnancy and a way to prevent it from ever happening again.[mymolarpregnancy.com]

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