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Gestational trophoblastic disease

Overview Symptoms Treatment Prevention
Alternative Names:
Chorioblastoma; Choriocarcinoma; Trophoblastic tumor; Chorioepithelioma; Invasive/malignant mole; Gestational trophoblastic neoplasia
Treatment:

After an initial diagnosis, a careful history and examination are done to rule out metastasis (spread to other organs). Chemotherapy is the treatment of choice.

A hysterectomy is rarely required, due to choriocarcinoma's extreme sensitivity to chemotherapy. More than 90% of women with malignant, nonmetastatic disease are able to maintain reproductive capabilities.

Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group.
Expectations (prognosis):

Nearly all women with malignant, nonmetastatic disease are cured, with more than 90% preserving reproductive function.

Some women with malignant, metastatic disease may have a poor prognosis if they meet one of the following conditions:

  • Spread to the liver or brain.
  • Serum HCG measurement greater than 40,000 mIU/ml at the time that treatment is started.
  • Having received prior chemotherapy.
  • Having symptoms (or the preceding pregnancy) for more than 4 months before treatment.
  • Term pregnancy associated with diagnosis. However, about 66% of women having a poor prognosis experience remission (a disease-free state).

Almost all women who receive a good prognosis with malignant, metastatic disease that does not meet one of these conditions experience remission.

Complications:

Choriocarcinoma may recur, usually within several months but possibly as late as 3 years after treatment ends. Complications associated with chemotherapy or surgery can also occur.

If a hysterectomy is performed, infertility will result. Menopause will begin if the ovaries are also removed.

Calling your health care provider:
Call for an appointment with your health care provider if symptoms arise within 1 year after hydatidiform mole, abortion (including miscarriage), or term pregnancy.
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