ICD-10 Codes
C58 Malignant neoplasm of placenta, choriocarcinoma. O01 Hydatidiform mole, molar pregnancy.
General Information
The term gestational trophoblastic disease (GTD) covers a number of trophoblast abnormalities with a prominent active production of hCG. These neoplasms have been known to science for centuries. Modern laboratory methods testing hCG levels can monitor the clinical course of disease accurately and to evaluate the outcomes of treatment. In 1956, methotrexate was first used successfully to treat a malignant trophoblast tumor, and this was the beginning of chemotherapy for trophoblastic disease.
The notion of GTD embraces such proliferative diseases as molar pregnancy, invasive mole, as well as placental-site trophoblastic tumor, epithelioid trophoblas-tic tumor and choriocarcinoma (a quite malignant condition). They develop from trophoblast cells; their primary localization site is the uterus.
The tissue of trophoblast normally shows the properties peculiar to the tissues of malignant tumor: rapid cell division, the ability to invade. However, when a pregnancy is over and trophoblast is naturally eliminated, these phenomena discontinue. In GTD the proliferation of trophoblast tissue continues even when the woman is no more pregnant.
NB! Molar pregnancy and trophoblastic tumors are always associated with pregnancy. Malignant trophoblastic tumor often develops after molar pregnancy.
GTD can manifest both during pregnancy and after its completion (from several days to several years postpartum or after any type of abortion). Malignant tropho-blastic tumor can develop after ectopic pregnancy as well.
Synonyms
Gestational trophoblastic disease, molar pregnancy, hydatidiform mole, invasive mole, placental-site trophoblastic tumor, epithelioid trophoblastic tumor, chorio-carcinoma.