Medicine an Surgery notes

Apr 24th, 2015
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GESTATIONAL TROPHOBLASTIC DISEASE LEARNIG OBJECTIVESAt the end of this chapter you should be able to:Describe the pathogenesis of gestational trophoblastic tumors(GTT)Describe the types of GTTDiscuss the risk factors and aetiology GTTDescribe the clinical presentation and diagnosis of GTTDiscuss the treatment modalities for GTTOutline the follow-up of a patient treated for GTTDescribe the prognosis and staging of GTTINTRODUCTION Gestational trophoblastic disease (GTD) defines a heterogeneous group of interrelated lesions derived from an aberrant fertilization event. The pathogenesis is unique because the maternal tumor arises from fetal, not maternal tissue.There are several histologically distinct types of disease: - Hydatidiform mole (complete or partial) - Persistent/invasive gestational trophoblastic disease - Choriocarcinoma - Placental site trophoblastic tumors Epitheloid trophoblastic tumorComplete and partial moles are benign. The last three categories represent malignant GTD (also called gestational trophoblastic neoplasia [GTN]) because of their potential for local invasion and metastases.EPIDEMIOLOGY There is some variation in the incidence of GTD throughout the world. In Japan, which has the highest incidence of GTD, hydatidiform mole complicates two of every 1000 pregnancies. The rate is lower in the United States, about one per 1000 pregnancies. Choriocarcinoma, in Africa is one of the leading malignant tumors in women. Differ

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