Gestational Trophoblastic Neoplasm (GTN) Witrak Flashcards Preview

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Flashcards in Gestational Trophoblastic Neoplasm (GTN) Witrak Deck (20):
1

What are the two broad categories of GTNs?

Hydatidiform mole (complete or partial)
Persistent (malignant)

2

What causes a mole?

Aberrant fertilization event

3

What causes the formation of a complete mole?

Fertilization of an empty ovum by sperm (2 or 1 that duplicates)

4

What is a complete mole?

Diploid; 46 XX or XY

5

What causes the formation of a partial mole?

Fertilization of an ordinary ovum by 2 sperm

6

What is a partial mole?

Triploid; 69 XXX, XXY, or XYY

7

What are the results of mole formation?

Most are evacuated w/o sequelae
10% persist/become invasive
2% risk of choriocarcinoma
Rare evolution to Placental Site Trophoblastic Tumor (PSTT)

8

When can choriocarcinoma present?

Months to > 1yr post gestation

9

What can choriocarcinoma arise from?

Any type of gestation

10

What are risk factors for GTNs?

Extremes of maternal age
Previous GTN

11

What symptoms could be seen with GTNs?

Vaginal bleeding
Large uterus for dates
Pelvic pressure
Hyperemesis gravidarum
Hyperthyroidism
Preeclampsia ocurring < 20wks

12

What addition symptoms would be seen with a choriocarcinoma?

Metastatic symptoms (lung, CNS)

13

There is diffuse vesicular enlargement of villi (gross vesicles) with NO fetal sac/fetus. What kind of mole is this?

Complete mole

14

There is variable vesicular enlargement of villi (gross vesicles) WITH fetal sac/fetus. What kind of mole is this?

Partial mole

15

What is a choriocarcinoma?

Hemorrhagic/necrotic tumor with mixtures of syncytiotrophoblastic and cytotrophoblastic cells with NO villus formation

16

What is a Placental Site Trophoblastic tumor (PSTT)?

Intermediate cytotrophoblastic cells that diffusely infiltrate the myometrium

17

How are GTNs diagnosed?

Really high hCG...like over 100,000

18

How are moles treated?

Evacuation

19

How is a persistent/malignant disease treated?

Single agent chemo treatment (Methotrexate)

20

When would a hysterectomy be done?

Rare cases...like chemo resistant PSTT