Gestational Trophoblastic Neoplasia

Excerpt

The first description of gestational trophoblastic disease (GTD) was by Hippocrates around 400 BC. However, it wasn't until 1895 that Felix Marchand discovered the association between pregnancy and GTD: when healthy trophoblastic tissue penetrates the endometrium, it creates the placenta, a rich uterine vasculature connecting the fetus and mother; with malignant tissue, invasion is characteristic.

Although the malignant behavior of a healthy trophoblast is well-controlled, in GTD, the regulatory mechanisms can become dysfunctional, resulting in highly invasive vascular and metastatic tumors. Gestational trophoblastic neoplasia (GTN) involves the malignant entities of GTD, including choriocarcinoma, invasive mole, epithelioid trophoblastic tumor (ETT), and placental site trophoblastic tumor (PSTT), all of which can metastasize and be fatal if not treated in a timely and effective manner.