Tienda-Pimentel M, Tienda Gonzáles M, Santos-Zapata R, Sánchez-Valdivieso E

Language: Spanish
References: 9
Page: 264-268
PDF size: 307.14 Kb.

ABSTRACT

Background: Gestational trophoblastic disease is a condition that includes a group of placental tumors resulting from abnormal proliferation of trophoblast tissue. It is characterized by an excessive elevation of human chorionic gonadotropin which is considered diagnostic and a prognostic predictor.
Clinical case: 23-year-old patient with hyperemesis gravidarum and uterine enlargement greater than 7 weeks' gestation and abnormally elevated HGC levels compared to baseline. The differential diagnoses of hydatidiform partial mole, complete mole and multiple pregnancy were ruled out. It was concluded that it was gestational trophoblastic disease. The uterine cavity was evacuated and abundant portions of ovoconformal and molariform tissue were extracted. The pathology report was: arcuate uterus with placental site tumor, chronic endometritis, cervicitis with squamous metaplasia, Nabot's cyst and late proliferative endometrium.
Conclusion: Since patients with gestational trophoblastic disease usually have a dismal prognosis simple hysterectomy is suggested to reach cure. Because of the aggressiveness of the tumor and resistance to other treatments, rigorous weekly monitoring of HCG quantification is indispensable.

REFERENCES

1. Strickland A.L, Gwin K. Gestational trophoblastic diseaserare,sometimes dramatic, and what we know so far. SeminDiagn Pathol [internet].2022 [Citado 27 Mayo 2022];39:228-237. http://doi.org/10.1053/j.semdp.2022.03.002

2. Gadduci A, Carinelli S, Guerrieri M.E, Aletti G.D. Placentalsite trophoblastic tumor and epithelioid trophoblastictumor: Clinical and pathological features, prognostic variablesand treatment strategy. J Gynecol Oncol [internet].2019 [Citado 27 Mayo 2022]; 153:684-693. https://doi.org/10.1016/j.ygyno.2019.03.011

3. Jauniaux E, Memtsa M, Johns J, Rossb J.A, Sebirec N.J, JurkovicaD. Ultrasound diagnosis of complete and partial hydatidiformmoles in early pregnancy failure: An inter-observerstudy. Placenta [internet]. 2020 [Citado 10 Mayo 2022];97: 65-67. https://doi.org/10.1016/j.placenta.2020.06.013

4. Dudiak K.M, Maturen K.E, Akin E.A, Bell M. et al. ACR AppropriatenessCriteria Gestational Trophoblastic Disease.JACR [internet]. 2019 [Citado 10 Mayo 2022];16: S348-S363. https://doi.org/10.1016/j.jacr.2019.05.015

5. Eiriksson L, Dean E, Sebastianelli A, Salvador S, et al. GuidelineNo. 408: Management of Gestational Trophoblastic Diseases.JOGC [internet].2021 [Citado 10 Mayo 2022];43:91-105. https://doi.org/10.1016/j.jogc.2020.03.001

6. Horowitz N.S, Goldstein D.P, Berkowitz R.S. Placental sitetrophoblastic tumors and epithelioid trophoblastic tumors:Biology, natural history, and treatment modalities. GynecolOncol [internet]. 2017 [Citado 27 Mayo 2022];144:208-214.http://dx.doi.org/10.1016/j.ygyno.2016.10.024

7. Hernández Flores SE, Vega Memije ME, Niebla CardenasD, Audifred Salomon JR. et al. Incidencia de EnfermedadTrofoblastica Gestacional en un Hospital General. GinecolObstet Mex 2016 jun;84(6):377-382

8. Nadhana R, Vamanb J.V, Sengodana S. K, Hemalatha K. S, RajanA, et al. Insights into dovetailing GTD and Cancers. Criti Rev OncolHematol [internet]. 2017 [Citado 27 Mayo 2022];144:77-

9. https://doi.org/10.1016/j.critrevonc.2017.04.0019. Braga A, Paiva G, Ghorani E, Freitas F, et al. Predictors forsingle-agent resistance in FIGO score 5 or 6 gestational trophoblasticneoplasia: a multicentre, retrospective, cohort study.Lancet Oncol [internet]. 2021 [Citado 10 Mayo 2022]; 22 :1188-1198. https://doi.org/10.1016/S1470-2045(21)00262-X