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Gestational Trophoblastic Disease (GTD)
Abnormal proliferation of trophoblastic (placental) tissue
• molar pregnancies
• invasive moles
• gestational choriocarcinoma
• placental site trophoblastic tumors
• epithelioid trophoblastic tumors
Five major classifications of GTD
b-hCG
Tumor marker for diagnosing GTD and as a tool for measuring the effects of treatment
Snowstorm pattern
Ultrasound findings for GTD
FIGO staging of malignant GTD

Revised FIGO scoring system for GTD

Persistent postmolar GTD and invasive mole
Hydropic chorionic villi and trophoblast proliferation into the myometrium
Gestational choriocarcinoma
Most common trophoblastic neoplasm to follow term pregnancy or miscarriage
• 50% after a complete molar pregnancy
• 25% after a normal-term pregnancy
• 25% after miscarriage, abortion, or ectopic pregnancy
Rate of gestational choriocarcinoma development
placental site trophoblastic tumors (PSTT)
Extremely rare tumors from invasion of the myometrium and vasculature from intermediate cytotrophoblasts of the placental implantation site
Epithelioid trophoblastic tumors
Rare tumor from chorionic-type intermediate trophoblast;
Uterus is mainly involved;
Presents with vaginal bleeding with low hCG levels