In contrast to the other types of trophoblast disease which characteristically present fairly soon after the index pregnancy, in PSTT the average interval between the prior pregnancy and presentation is 3.4 years. [hmole-chorio.org.uk]

Here is a case which presented with history of evacuation for molar pregnancy. [scopemed.org]

652.4 failure, fetal head to enter pelvic brim 652.5 false labor (pains) 644.1 fatigue 646.8 fatty metamorphosis of liver 646.7 female genital mutilation 648.9 fetal fibroid (tumor) (uterus) 654.1 footling presentation 652.8 gallbladder disease 646.8 [icd9data.com]

[…] features Most common form of persistent or metastatic gestational trophoblastic disease (GTD) after hydatidiform mole; occurs 6 - 10 times more frequently than choriocarcinoma Defined as molar gestation invading myometrium or uterine vessels Commonly presents [pathologyoutlines.com]

Analysis of zygosity of CHMs with and without invasion at presentation, including invasive CHMs with concurrent atypical trophoblastic proliferations concerning for or consistent with choriocarcinoma, has not been specifically addressed. [journals.lww.com]

• Anemia

  Pregnancy (single) (uterine) (without sickness) V22.2 complicated (by) 646.9 abnormal, abnormality NEC 646.9 abscess or cellulitis adhesion, pelvic peritoneal 648.9 air embolism 673.0 albuminuria 646.2 amnionitis 658.4 amniotic fluid embolism 673.1 anemia [icd9data.com]

  Spread to the intestinal tract may also be associated with chronic blood loss and anemia or with massive hemorrhage. Brain metastases are often associated with symptoms that suggest a brain tumor or stroke. [womenscancercenter.com]

  […] choriocarcinoma also can cause the following symptoms: Abdominal swelling, caused by the uterus becoming larger, that occurs more rapidly than expected for the first trimester of pregnancy Excessive vomiting during pregnancy Fatigue, often caused by anemia [drugs.com]

  Pre contrast (gadolinium) sagittal T1W SPIR image showing the heterogeneous appearance of the lesion (arrow) distending the endometrial cavity. ment of her anemia. [file.scirp.org]

  This disease is marked by an enlarged spleen and progressive anemia. [cancer.gov]

• Aspiration

  This process could be monitored by high levels of hCG in serum for months due to persisting trophoblast proliferation, even after terminating the gravid cycle by abortion or vacuum aspiration. [collections.lib.utah.edu]

  Certain types of Aspergillus may cause disease, especially in people who have suppressed immune systems. aspirate Aspirate (pronounced AS-pih-rit) refers to fluid, tissue, or other substance that is withdrawn from a body cavity, cyst, or tumor. [cancer.gov]

• Hypertension

  see Hypertension, complicating pregnancy hypertensive hyperthyroidism 648.1 hypothyroidism 648.1 hysteralgia 646.8 icterus gravis 646.7 incarceration, uterus 654.3 incompetent cervix (os) 654.5 infection 647.9 infective and parasitic diseases NEC 647.8 [icd9data.com]

  116 106 Amniotic Fluid and Placental Abnormalities 121 Preterm Labour 132 Postmaturity 141 Intrauterine Growth Retardation 146 Macrosomia and Stillbirth 154 MEDICAL DISORDERS COMPLICATING PREGNANCY 159 Anaemias 160 Cardiac Diseases in Pregnancy 170 Hypertensive [books.google.com]

  […] presentation ( J Prenat Med 2009;3:15 ) Disproportionately large uterus for the stage of pregnancy Increasing serum hCG levels after the 14th week, as opposed to the drop typically seen in the course of normal gestation Evidence of toxemia of pregnancy (hypertension [pathologyoutlines.com]

  […] complete hydatidiform mole is suspected in a patient whose uterus is larger than expected for gestational age; there is a vaginal bleeding, a repeatedly and markedly elevated hCG level; frequently a first trimester preeclampsia (pregnancy associated hypertension [gfmer.ch]

  […] pregnancy Most common symptom is abnormal vaginal bleeding – usually 6-16 weeks gestation Other symptoms include the following Uterine enlargement not commensurate with stage of pregnancy Absent fetal heart tones Hyperemesis gravidarum Pregnancy-induced hypertension [arupconsult.com]

• Heart Disease

  Free radicals may play a part in cancer, heart disease, stroke, and other diseases of aging. [cancer.gov]

• Fear

  They may also have a fear of being alone or have trouble leaving their home. They usually avoid elevators, bridges, and public places. [cancer.gov]

If malignancy is suspected, workup must include an x-ray of the chest to screen for lung metastases. Hydatidiform moles are normally treated via dilation and curettage, whereas choriocarcinoma typically requires chemotherapy. [amboss.com]

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]

• Polyps

  ACF form before colorectal polyps and are one of the earliest changes that can be seen in the colon that may lead to cancer. [cancer.gov]

• Trophoblastic Cells

  PSTT is diploid and arises from the non-villous trophoblast and the pathology is characterised by intermediate trophoblastic cells with vacuolated cytoplasm, the expression of PLAP rather than hCG and the absence of cytotrophoblast and villi. [hmole-chorio.org.uk]

  Gestational trophoblastic disease (GTD) comprises a group of rare tumors originating from cells that would normally develop into the placenta during pregnancy. [arupconsult.com]

  General Information About Gestational Trophoblastic Disease Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. [northshore.org]

  Sheets of anaplastic trophoblastic cells are noted without the maintenance of the pattern of the villi. Extensive necrosis is evident. Back to Top [glowm.com]

  It derives from intermediate trophoblastic cells of the corion laeve and is usually associated with a previous gestational event. [giog.it]

An invasive mole can be treated with an ultrasound-guided local injection of MTX in addition to the established systemic MTX treatment. [ncbi.nlm.nih.gov]

The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]

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. [northshore.org]

Despite metastasizing GTD with poor prognosis criteria she was treated with single agent therapy. Eight cycles of two weekly methotrexate (MTX) were administered. [ncbi.nlm.nih.gov]

Prognosis With appropriate treatment, all hydatidiform moles are curable, and nearly all cases of more aggressive molar tumors can be cured. [drugs.com]

Monitor β- HCG levels until in reference range (usually 8–12 weeks) Chemotherapy (usually methotrexate ) if unresolved, as indicated by any of the following: Prognosis References: [1] [2] [3] [4] [5] [6] Choriocarcinoma Definition Highly aggressive, malignant [amboss.com]

Life events and breast cancer prognosis. BMJ: British Medical Journal. 1992;304(6842):1632. McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemeroff CB, et al. Depression in patients with cancer: diagnosis, biology and treatment. [ijrcog.org]

It might have already metastasized when it is diagnosed which carries a poorer prognosis (outlook). [cancer.org]

Etiology Etiology is not known. Diagnostic methods Histologically, invasive moles are characterized by hyperplasia of trophoblasts, generalized cystic degeneration of chorionic villi and the presence of molar villi in the myometrium. [orpha.net]

[…] an invasive mole Etiology Risk factors Prior molar pregnancy History of miscarriage Patients ≤ 15 and ≥ 35 years Complete mole Does not contain any fetal or embryonic parts Caused by fertilization of an empty egg that does not carry any chromosomes → [amboss.com]

Of the 272 non-molar specimens, 259 were p57-positive biparental diploid ( Figures 3e–h and 9 ), 5 were p57-positive digynic triploid, 2 were p57-negative biparental diploid (uncertain etiology for loss of p57 expression as there were no morphological [nature.com]

Epidemiology of gestational trophoblastic diseases. Best Pract Res Clin Obstet Gynecol. 2003;17:837-47. Sebire NJ, Foskett RA, Fisher RA, Rees H, Seckl M, Newlands E. [ijrcog.org]

Summary Epidemiology Annual incidence and prevalence are not known. [orpha.net]

Gynecol Oncol. 100(3): 511–520 PubMed CrossRef Google Scholar Bagshawe KD (1992) Trophoblastic tumors: diagnostic methods, epidemiology, clinical features and management. In: Coppleson M (ed) Gynecologic oncology. [link.springer.com]

Epidemiology of hydatidiform mole during early gestation. Am J Obstet Gynecol. 1986 Apr. 154(4):906-9. [Medline]. Grimes DA. Epidemiology of gestational trophoblastic disease. Am J Obstet Gynecol. 1984 Oct 1. 150(3):309-18. [Medline]. [emedicine.medscape.com]

Pathophysiology Hydropic degeneration of chorionic villi with concomitant proliferation of cytotrophoblasts and syncytiotrophoblasts → death of the embryo Clinical features Complete mole Vaginal bleeding during the first trimester Uterus size greater [amboss.com]

Asian countries (Philippines: 1:173; India: 1:160; Taiwan: 1:125; and Indonesia: 1:82) ( Am J Obstet Gynecol 1964;90:308, Ann N Y Acad Sci 1959;80:178 ) Extremes of age (< 20 and > 40 years) and previous history of mole Dietary deficiency of vitamin A Pathophysiology [pathologyoutlines.com]

[…] hydatidiform molar pregnancy Asian or American Indian ancestry, or (for GTN only) African ancestry Older maternal age – women >40 years Familial disease – rare, more common in recurrent CHM NLRP7 and (rarely) KHDC3L gene mutations implicated (Wang, 2009) Pathophysiology [arupconsult.com]

Pathophysiology A complete mole contains no fetal tissue. Ninety percent are 46,XX, and 10% are 46,XY. [3, 4] Complete moles can be divided into two types, androgenetic complete mole and biparental complete mole. [emedicine.medscape.com]

To prevent the morbidity and mortality associated with postmolar malignant sequelae, prophylactic hysterectomy was advocated by some (5), but it could not prevent metastasis in other body parts besides sacrificing the reproductive potential in young patients [ispub.com]

Prevent and plan for potential complications associated with the advancing age of pregnant women. [books.google.com]

Aloxi listen (uh-LOK-see) A drug used to prevent nausea and vomiting caused by chemotherapy. It is also used to prevent nausea and vomiting after surgery. [cancer.gov]

[…] histology Differential Diagnosis Partial Mole Missed abortion Choriocarcinoma Treatment Treatment involves evacuation of uterine contents by dilation and curettage Alternatively, patients who do not desire further fertility may opt for a hysterectomy to prevent [learningradiology.com]

Prevention Although any woman who becomes pregnant is at some risk of developing one of these uncommon conditions, the risk appears to be higher in pregnant women who are younger than age 20 or older than age 40. [drugs.com]