TROPHOBLASTIC TUMORS

Gestational trophoblastic tumor is a rare cancer that occurs in a woman’s reproductive system. Gestational trophoblastic tumor is a disease in which cancer cells grow in the tissues that are formed following the joining of sperm and egg. Gestational trophoblastic tumors start inside the uterus.Cancer begins when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). Gestational trophoblastic tumors occurs in women during the years when they are able to have children.

Trophoblastic tumor is a result of an abnormal pregnancy due to an abnormal combination of a sperm and an egg. Sometimes the trophoblastic tumor can be a cancerous growth that begins from a normal placenta. The placenta is the organ that develops during pregnancy and connects the fetus (unborn baby) to the uterus, also called the womb.

Trophoblastic Tumor Types

Hydatidiform mole. Hydatidiform mole is the most common form of gestational trophoblastic tumors. Often it is called a molar pregnancy which is the most common – approximately 80% from all types of the trophoblastic tumors. There are two types of molar pregnancy - complete molar pregnancy and partial molar pregnancy.
Complete molar pregnancy usually begins when a sperm fertilizes an abnormal egg. Instead of forming an embryo, the tissue grows into a mound of cells that look like grape-like cysts. There is no evidence of normal fetal development.

Partial molar pregnancy begins with fertilization of an egg by two sperm. It has some of the features of a complete molar pregnancy, but also has some fetal development. The fetus has abnormal chromosomes and has no potential for survival.

Very specific type of molar pregnancy is the invasive molar pregnancy which most commonly begins from a complete molar pregnancy. Rare invasive molar pregnancy can also arise from a partial molar pregnancy. Most hydatidiform moles do not spread outside of the uterus. It is noted that approximately in 15% cases the hydatidiform moles can be spread outside of the uterus.

Choriocarcinoma. Choriocarcinoma is a malignant form of gestational trophoblastic tumors. This type of trophoblastic tumor may begin as a hydatidiform mole or from the placenta, whether through delivery of a baby, abortion or miscarriage. Most often the Choriocarcinoma can occur after a normal pregnancy or an abortion. Choriocarcinoma is more likely to spread outside of the uterus - to organs away from the uterus. Choriocarcinoma can spread. The frequency of choriocarcinomas is approximately 5%.

Placental-site trophoblastic disease. This rare type of trophoblastic tumor can start in the placenta.

Trophoblastic Tumor Symptoms

During early stages the trophoblastic tumors can be asymptomatic which is increasing the risk of late diagnosis.

Most typical symptoms of the trophoblastic tumors include:

	Vaginal bleeding not related to menstruation;
	Lack of fetal movement;
	Increased human chorionic gonadotropin level (sometimes higher than during normal pregnancy development);
	Enlarged uterus;
	Pain.

Trophoblastic Tumor Causes

General categories of medical conditions which can be a cause for the triphoblactic tumors include:

	Pregnancy-related conditions,
	Women's health conditions,
	Women-only conditions,
	Cancer,
	Soft tissue tumors.

How Trophoblastic Tumor can be discovered

Gestational trophoblastic tumor is not always easy to find. In its early stages, it may look like a normal pregnancy. You should visit your doctor if during early pregnancy you have vaginal bleeding (not menstrual bleeding) and if during late pregnancy baby hasn't moved at the expected time.

In case of unusual pregnancy symptoms, doctor can use several tests to see if the patient has a gestational trophoblastic tumor. An internal (pelvic) examination is usually the first of these tests. The doctor will feel for any lumps or strange feeling in the shape or size of the uterus. Next test can be ultrasound which can easily identify the trophoblastic tumor. The blood test will also be done to look for high levels of a hormone called hCG (human chorionic gonadotropin) which is present during normal pregnancy. During trophoblastic tumor usually the concentration of hCG is higher. If a woman is not pregnant and hCG is in the blood - it can be a sign of gestational trophoblastic tumor.

The chance of recovery (prognosis) and choice of treatment depend on the type of gestational trophoblastic tumor, whether it has spread to other places, and the patient's general state of health.