Hydatidiform moles and gestational trophoblastic neoplasia

Background. Trophoblastic diseases including hydatidiform moles (complete or partial), choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor are a heterogeneous group of tumors also referred to as gestational trophoblastic neoplasia (GTN). Aim of this paper. An overview on the clinical manifestations, diagnostics and the current treatment of GTN is provided in this article. Clinical manifestations. The most common clinical symptoms are vaginal bleeding or an enlarged uterus. Serum human chorionic gonadotropin (HCG) levels are elevated. In the rare case of metastases these symptoms can lead to the primary tumor. Diagnostics. Ultrasound of the uterus in combination with determination of serum HCG levels is the gold standard for the diag-nosis. Once a malignancy is suspected histological confirmation is necessary. If a GTN is diagnosed a screening for distant metastases is recommended. Therapy. The recommended therapy of hydatidiform moles is ultrasound-guided vacuum curettage. Depending on the stage of a GTN the treatment varies between single agent and polychemotherapy. Conclusion. Although trophoblastic malignancies are rare tumors, maternal morbidity is considerable high. Early diagnosis and adequate stage-oriented therapy increase the prognosis for patients.