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]
Entire Body System
- Pathologist
This book will be of great value to pathologists, community gynecologists, gynecological pathologists and medical students. [books.google.com]
Our multidisciplinary team of gynecologic oncologists, radiation oncologists, radiologists, and pathologists coordinate the best care for each patient from diagnosis to treatment to monitoring for recurrence. Learn more [inova.org]
A team of gynecologic oncologists, radiation oncologists, reconstructive surgeons, colorectal surgeons, pathologists and radiologists will collaborate to provide a personalized treatment for you. [uoflphysicians.com]
[…] and are setting treatment guidelines for other physicians around the world Gynecologic medical oncologists who are constantly evaluating novel, targeted therapies through clinical trials, some of which may not be available elsewhere Our gynecologic pathologists [brighamandwomens.org]
- Fatigue
[…] pregnancy, which may include headaches and/or swelling of the feet and hands A pregnancy where the baby has not moved at the expected time Pain or pressure in the pelvic area Abdominal swelling Anemia, which is a low red blood cell count that can cause fatigue [cancer.net]
Other symptoms include: Abdominal bloating Nausea and vomiting, which is generally more severe than in normal pregnancy Fatigue, shortness of breath, and lack of energy due to anemia, if there has been a great deal of blood loss Signs of an overactive [dana-farber.org]
Ten months following the birth of her daughter, Jane was admitted to hospital with fever, fatigue, shortness of breath and haemoptysis. [sharinginhealth.ca]
[…] symptoms: irregular, non-menstrual vaginal bleeding, possibly with blood clots or a watery brown discharge pelvic pain or discomfort nausea and vomiting that are more frequent and severe than what a woman typically experiences during a normal pregnancy fatigue [mskcc.org]
Other symptoms are: Abdominal bloating Nausea and vomiting which is generally more severe than in normal pregnancy Fatigue, shortness of breath and lack of energy due to anemia, if there has been a great deal of blood loss Signs of an overactive thyroid [foundationforwomenscancer.org]
- Weight Loss
loss Occasionally, symptoms may appear weeks, months, or even years after a normal pregnancy and birth. [cancer.net]
loss Diagnosis You find out you have GTD from the routine tests you get when you’re pregnant. [webmd.com]
loss Symptoms similar to preeclampsia that occur in the first trimester or early second trimester, including high blood pressure and swelling in the feet, ankles, and legs (this is almost always a sign of a hydatidiform mole, because preeclampsia is [nlm.nih.gov]
Respiratoric
- Dyspnea
Even though she is functional, she still has dyspnea of functional class II of New York Heart Association (NYHA). [omicsonline.org]
She denied fever, chills, emesis, syncope, dyspnea, chest pain, or vaginal bleeding, and she had no urinary symptoms. [westjem.com]
Kelly et al identified several prognostic factors for early respiratory death in patients presenting with GTT and dyspnea [105]. [cancernetwork.com]
Lung metastases are usually symptomless, but may be extensive and cause dyspnea, cough, hemoptysis and thoracic pain 1, 4. Vaginal metastatic nodules are more frequent in the fornices and suburethral region. [scielo.br]
Gastrointestinal
- Abdominal Bloating
Other symptoms include: Abdominal bloating Nausea and vomiting, which is generally more severe than in normal pregnancy Fatigue, shortness of breath, and lack of energy due to anemia, if there has been a great deal of blood loss Signs of an overactive [dana-farber.org]
Other symptoms are: Abdominal bloating Nausea and vomiting which is generally more severe than in normal pregnancy Fatigue, shortness of breath and lack of energy due to anemia, if there has been a great deal of blood loss Signs of an overactive thyroid [foundationforwomenscancer.org]
Other symptoms are Abdominal bloating Nausea and vomiting, which are generally more severe than in normal pregnancy Fatigue, shortness of breath, and lack of energy due to anemia, if there has been a great deal of blood loss Signs of an overactive thyroid [mymolarpregnancy.com]
bloating, night sweats, and constipation. [cancerindex.org]
- Lower Abdominal Pain
On admission she had irregular vaginal bleeding, lower abdominal pain, syncopa, headache, excessive vomiting, transvaginal expulsion of grape-like vesicles, an abnormally enlarged uterus and features of eclampsia. [signavitae.com]
Patients often present with an adnexal mass, lower abdominal pain mimicking an ectopic pregnancy, and, rarely, hemoperitoneum. Elevated serum hCG may cause isosexual precocity in children. [archivesofpathology.org]
The patient suffered from lower abdominal pain, irregular bleeding and vomiting. urine-human chorionic gonadotropin (U-hCG) was positive. Ultrasonography showed the typical 'snow-storm' images of a mole pregnancy. [cancerindex.org]
- Diarrhea
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]
Diarrhea. Hematologic toxicity. Hepatic toxicity. There was a statistically significant increase in dermatologic toxicity, including alopecia, associated with dactinomycin. [cancer.gov]
Approximately 20% suffered diarrhea, with 15 patients developing pseudomembranous colitis. [glowm.com]
Cardiovascular
- Tachycardia
These factors included cyanosis, pulmonary hypertension, anemia, tachycardia, extensive lung opacification, and a high WHO prognostic score. [cancernetwork.com]
Beta blockers, such as metoprolol, may be required to control tachycardia and hypertension associated with secondary hyperthyroidism. [cancertherapyadvisor.com]
Skin
- Sweating
[…] expected time Pain or pressure in the pelvic area Abdominal swelling Anemia, which is a low red blood cell count that can cause fatigue, dizziness, shortness of breath, or an irregular heartbeat Anxiety or irritability, including feeling shaky or severe sweating [cancer.net]
Throwing up and upset stomach that are much more intense than a normal pregnancy Vaginal bleeding not related to your menstrual cycle GTD may also lead to an overactive thyroid, causing symptoms such as: Heartbeat that’s fast or not regular Shakiness Sweating [webmd.com]
Sweating. Frequent bowel movements. Trouble sleeping. Feeling anxious or irritable. Weight loss. Tests that examine the uterus are used to detect (find) and diagnose gestational trophoblastic disease. [vicc.org]
Urogenital
- Hematuria
Lal et al. [ 13 ] reported a case of spontaneous renal hemorrhage in a patient with metastatic choriocarcinoma presenting with gross hematuria that was successfully managed with angioembolization. [synapse.koreamed.org]
If metastases exist, signs and symptoms associated with the metastatic disease, such as hematuria, hemoptysis, abdominal pain, and neurologic symptoms, may be present. [csh.org.tw]
- Vaginal Discharge
Clinical examination confirmed an abdominal uterine mass of 22 weeks’ gestation with a foul-smelling vaginal discharge. [sajhivmed.org.za]
Workup
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]
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]
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]
Treatment
When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Clinical trials are taking place in many parts of the country. [vicc.org]
Duration of disease from the initial pregnancy event to start of treatment. Number and specific sites of metastases. Nature of antecedent pregnancy. Extent of prior treatment. [cancer.gov]
To diagnose this condition, a patient’s Ob/Gyn might perform several tests, such as: Physical exam and medical history Pelvic exam Ultrasound Blood chemistry study Serum tumor marker test Urinalysis Treatment UT Southwestern offers the latest treatments [utswmed.org]
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]
In some cases, further treatment is required. Treatment for GTD is usually chemotherapy (drug treatment), but surgery is sometimes an option. [imperial.nhs.uk]
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]
Prognosis and staging [ edit ] Women with a hydatidiform mole have an excellent prognosis. [en.wikipedia.org]
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
Yen, S. and MacMahon, B., Epidemiologic features of trophoblastic disease, Amer. J. Obstet. Gynecol. 101: 126 (1968). Google Scholar 11. Prawirohardjo, S., Martiono, K. [link.springer.com]
Palmer JR (1994) Advances in the epidemiology of gestational trophoblastic disease. J Reprod Med 39:155–162 PubMed Google Scholar 7. [dx.doi.org]
[…] patient information, click here Gestational trophoblastic neoplasia Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Gestational trophoblastic neoplasia from other Diseases Epidemiology [wikidoc.org]
"Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole". [en.wikipedia.org]
Pathophysiology
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]
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. [doi.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
Gestational Trophoblastic Disease Prevention There are no preventive medicines or treatments for GTD. The only way to prevent this very rare disease is to not become pregnant. [hopkinsmedicine.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]
GTD occurs after conception, when the trophoblast cells change and form a mass in the placenta, preventing a healthy fetus from developing. [cancercenter.com]
[…] 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]
For more information on the causes, risk factors, symptoms, diagnosis, prevention, and treatment of GTD, visit the following sites: Michigan Medicine Health Library American Cancer Society National Cancer Institute [rogelcancercenter.org]