Gestational trophoblastic neoplasia causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]
Overview
Complete hydatidiform mole arises when an ovum without maternal chromosomes is fertilized by one sperm which duplicates its DNA, resulting in a 46XX androgenetic karyotype. Partial hydatidiform moles are almost always triploid, resulting from the fertilization of a healthy ovum by two sperms. Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma. Gestational type choriocarcinoma arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion. Non-gestational type choriocarcinoma arises from pluripotent germ cells. Placental-site trophoblastic tumor (PSTT) arises from the placental implantation site when the trophoblastic cells infiltrate the myometrium. Epithelioid trophoblastic tumor (ETT) arises from the intermediate trophoblastic cells of chorion laeve.
Causes
The causality of gestational trophoblastic neoplasia based on the sub-types is as follows:
Invasive mole
- It arises from myometrial invasion of hydatidiform mole via direct extension through tissue or venous channels.
- Approximately 15~20% of complete hydatidiform moles (CHMs) and less than 1~5% of partial hydatidiform moles (PHMs) can undergo malignant transformation into an invasive mole.[1][2][3]
- In rare instances, invasive mole can arise from iatrogenic uterine perforation.[4]
Choriocarcinoma
- Abnormal trophoblastic population undergoing hyperplasia and anaplasia can give rise to choriocarcinoma.[5]
- Gestational type arises following a hydatidiform mole, normal pregnancy, or most commonly, abortion.[6]
- Non-gestational type arises from pluripotent germ cells.[6]
Placental-site Trophoblastic Tumor (PSTT)
- It arises from the placental implantation site when the trophoblastic cells infiltrate the myometrium.[7]
Epithelioid Trophoblastic Tumor (ETT)
- It arises from the intermediate trophoblastic cells of chorion laeve.[8]
References
- ↑ El-Helw LM, Hancock BW (August 2007). "Treatment of metastatic gestational trophoblastic neoplasia". Lancet Oncol. 8 (8): 715–24. doi:10.1016/S1470-2045(07)70239-5. PMID 17679081.
- ↑ Seckl MJ, Sebire NJ, Berkowitz RS (August 2010). "Gestational trophoblastic disease". Lancet. 376 (9742): 717–29. doi:10.1016/S0140-6736(10)60280-2. PMID 20673583.
- ↑ Shih I (July 2007). "Gestational trophoblastic neoplasia--pathogenesis and potential therapeutic targets". Lancet Oncol. 8 (7): 642–50. doi:10.1016/S1470-2045(07)70204-8. PMID 17613426. Vancouver style error: initials (help)
- ↑ Shen, Yuanming; Wan, Xiaoyun; Xie, Xing (2017). "A metastatic invasive mole arising from iatrogenic uterus perforation". BMC Cancer. 17 (1). doi:10.1186/s12885-017-3904-2. ISSN 1471-2407.
- ↑ Lurain JR (December 2010). "Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole". Am. J. Obstet. Gynecol. 203 (6): 531–9. doi:10.1016/j.ajog.2010.06.073. PMID 20728069.
- ↑ 6.0 6.1 Stockton L, Green E, Kaur B, De Winton E (2018). "Non-Gestational Choriocarcinoma with Widespread Metastases Presenting with Type 1 Respiratory Failure in a 39-Year-Old Female: Case Report and Review of the Literature". Case Rep Oncol. 11 (1): 151–158. doi:10.1159/000486639. PMC 5903105. PMID 29681814.
- ↑ https://www.cancer.gov/types/gestational-trophoblastic
- ↑ Stănculescu RV, Bauşic V, Vlădescu TC, Vasilescu F, Brătilă E (2016). "Epithelioid trophoblastic tumor: a case report and literature review". Rom J Morphol Embryol. 57 (4): 1365–1370. PMID 28174805.