Gestational Trophoblastic Disease

Radiologic-Pathologic Correlation

Abstract Introduction Normal And Abnormal Trophoblast Epidemiologic Characteristics

Hydatidiform Mole Complete Hydatidiform Mole Invasive Mole Choriocarcinoma Partial Hydatidiform Mole

Placental Site Trophoblastic Disease Conclusions Source Information References

Placental Site Trophoblastic Disease

Placental site trophoblastic disease is a very rare neoplasm that some believe represents a type of choriocarcinoma. At pathologic analysis, though, these tumors are composed predominantly of intermediate trophoblasts and lack the biphasic features of choriocarcinoma (which typically contains cytotrophoblast and syncytiotrophoblast) (5,7). The patients present with either abnormal bleeding or amenorrhea; in the latter situation, the patient might be presumed to be pregnant. This is potentially problematic, because the beta-hCG level is usually "positive" for pregnancy (7). Relative to other forms of GTD, though, the levels of beta-hCG are quite low (6) because of the lack of syncytiotrophoblast proliferation.

These tumors vary widely in clinical course; many behave in a benign fashion, whereas others are highly malignant. In general, surgery (hysterectomy) is the accepted treatment (30). The tumor may be microscopic or may cause diffuse nodular enlargement of the myometrium; it may project into the uterine lumen or predominantly invade the myometrium (7). Radiologic manifestations vary but include both cystic and solid lesions, with or without a central component, which usually invade the myometrial wall. Thus, the uterus with placental site trophoblastic disease may have an appearance similar to a uterus involved by invasive mole or choriocarcinoma (5,7,18,32) (Figure 19).

Abstract Introduction Normal And Abnormal Trophoblast Epidemiologic Characteristics

Hydatidiform Mole Complete Hydatidiform Mole Invasive Mole Choriocarcinoma Partial Hydatidiform Mole

Placental Site Trophoblastic Disease Conclusions Source Information References