Gestational Trophoblastic Neoplasia

INTRODUCTION

Includes

•  Hydatidiform mole—Complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) (Table 24.1)

•  Invasive mole (chorioadenoma destruens)

•  Coexistent complete mole and live fetus

•  Choriocarcinoma

•  PSTT—Placental site trophoblastic tumor

Presentation

Vaginal bleeding

Uterine enlargement more than expected for gestational age (GA)

Abnormally high hCG levels

Prevaginal passage of vesicles

Low levels of maternal serum alpha-fetoprotein (MSAFP)

IMAGING

USG

Enlarged uterine cavity filled with heterogeneous mass with cystic spaces of varying sizes (BUNCH OF GRAPES appearance) (Figure 24.1)

•  No fetal development in complete mole.

•  B/L theca—lutein cysts in enlarged ovaries.

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