Gestational trophoblastic neoplasia differential diagnosis: Difference between revisions
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* Hysterectomy | * Hysterectomy | ||
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|'''Ovarian Tumors'''<ref name="pmid2050306">{{cite journal |vauthors=Farahmand SM, Marchetti DL, Asirwatham JE, Dewey MR |title=Ovarian endodermal sinus tumor associated with pregnancy: review of the literature |journal=Gynecol. Oncol. |volume=41 |issue=2 |pages=156–60 |date=May 1991 |pmid=2050306 |doi= |url=}}</ref><ref name="pmid3806533">{{cite journal |vauthors=Hopkins MP, Duchon MA |title=Adnexal surgery in pregnancy |journal=J Reprod Med |volume=31 |issue=11 |pages=1035–7 |date=November 1986 |pmid=3806533 |doi= |url=}}</ref><ref name="pmid3532382">{{cite journal |vauthors=Lavery JP, Koontz WL, Layman L, Shaw L, Gumpel U |title=Sonographic evaluation of the adnexa during early pregnancy |journal=Surg Gynecol Obstet |volume=163 |issue=4 |pages=319–23 |date=October 1986 |pmid=3532382 |doi= |url=}}</ref> | |'''Ovarian Tumors'''<ref name="pmid2050306">{{cite journal |vauthors=Farahmand SM, Marchetti DL, Asirwatham JE, Dewey MR |title=Ovarian endodermal sinus tumor associated with pregnancy: review of the literature |journal=Gynecol. Oncol. |volume=41 |issue=2 |pages=156–60 |date=May 1991 |pmid=2050306 |doi= |url=}}</ref><ref name="pmid3806533">{{cite journal |vauthors=Hopkins MP, Duchon MA |title=Adnexal surgery in pregnancy |journal=J Reprod Med |volume=31 |issue=11 |pages=1035–7 |date=November 1986 |pmid=3806533 |doi= |url=}}</ref><ref name="pmid3532382">{{cite journal |vauthors=Lavery JP, Koontz WL, Layman L, Shaw L, Gumpel U |title=Sonographic evaluation of the adnexa during early pregnancy |journal=Surg Gynecol Obstet |volume=163 |issue=4 |pages=319–23 |date=October 1986 |pmid=3532382 |doi= |url=}}</ref><ref name="pmid2722058">{{cite journal |vauthors=Dgani R, Shoham Z, Atar E, Zosmer A, Lancet M |title=Ovarian carcinoma during pregnancy: a study of 23 cases in Israel between the years 1960 and 1984 |journal=Gynecol. Oncol. |volume=33 |issue=3 |pages=326–31 |date=June 1989 |pmid=2722058 |doi= |url=}}</ref> | ||
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* Vagina bleeding or discharge | * Vagina bleeding or discharge | ||
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* Overall incidence in pregnancy is 2.4-5.7% (1/300 to 1/556 pregnancies) | * Overall incidence in pregnancy is 2.4-5.7% (1/300 to 1/556 pregnancies) | ||
* Incidence of malignancy is 1/15,000 to 1/32,000 pregnancies | |||
* Germ cell and epithelial tumors are most common | |||
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Revision as of 14:46, 4 March 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]
Overview
Choriocarcinoma must be differentiated from non neoplastic diseases, neoplastic diseases, and other causes of bleeding during pregnancy.
Differentiating choriocarcinoma from other diseases
Choriocarcinoma must be differentiated from other non-neoplastic diseases such as:
Choriocarcinoma must be differentiated from other neoplastic diseases such as:
- Invasive hydatidiform mole
- Placental site trophoblastic tumor (PSTT)
- Mixed germ cell tumor - esp. for testicular and ovarian tumors
Choriocarcinoma must be differentiated from other causes of bleeding during pregnancy:
- Spontaneous abortion
- Ectopic pregnancy
- Normal term pregnancy
| Differential Diagnosis | Clinical Features | Karyotype | Immunostaining | Management | |||||||||||
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| Presenting Complaints | Potential for Neoplastic Conversion | Beta Human Chorionic Gonadotropin (Beta-hCG) Baseline Levels | History of Pregnancy | Theca Leutin Cysts | Metastatic Route | Cytokeratin 18 | HLA-G | Human Chorionic Gonadotropin (hCG) | Transformation-Related Protein 63 (P63) | Human Placental Lactogen (hPL) | Melanoma Cell Adhesion Molecule (Mel-CAM) | Ki67 | |||
| Complete Hydatidiform Mole |
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| Partial Hydatidiform Mole |
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| Invasive Molar Pregnancy |
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| Choriocarcinoma |
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| Placental-site Trophoblastic tumor (PSTT) and Epitheloid Trophoblastic Tumor (ETT) |
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| Ovarian Tumors[1][2][3][4] |
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| Spontaneous Abortion |
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| Ectopic Pregnancy | |||||||||||||||
| Normal Term Pregnancy | |||||||||||||||
| Clinical Features | Complete Hydatidiform Mole | Partial Hydatidiform Mole | Invasive Molar Pregnancy | Choriocarcinoma | Placental-site trophoblastic tumor (PSTT) and Epithelioid trophoblastic tumor (ETT) |
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| Presenting Complaints |
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| Neoplastic Conversion |
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| Beta Human Chorionic Gonadotropin (Beta-hCG) baseline levels |
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| History of Pregnancies |
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| Metastatic Route | |||||
| Management |
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References
- ↑ Farahmand SM, Marchetti DL, Asirwatham JE, Dewey MR (May 1991). "Ovarian endodermal sinus tumor associated with pregnancy: review of the literature". Gynecol. Oncol. 41 (2): 156–60. PMID 2050306.
- ↑ Hopkins MP, Duchon MA (November 1986). "Adnexal surgery in pregnancy". J Reprod Med. 31 (11): 1035–7. PMID 3806533.
- ↑ Lavery JP, Koontz WL, Layman L, Shaw L, Gumpel U (October 1986). "Sonographic evaluation of the adnexa during early pregnancy". Surg Gynecol Obstet. 163 (4): 319–23. PMID 3532382.
- ↑ Dgani R, Shoham Z, Atar E, Zosmer A, Lancet M (June 1989). "Ovarian carcinoma during pregnancy: a study of 23 cases in Israel between the years 1960 and 1984". Gynecol. Oncol. 33 (3): 326–31. PMID 2722058.