Gestational Trophoblastic Disease

Definition:

 Gestational Trophoblastic Disease (GTD) results from abnormal proliferation of trophoblastic tissue, and encompasses a wide spectrum of diseases, including:

> Hydatidiform Mole

   -Complete Mole

   -Partial Mole

>Invasive Mole

>Choriocarcinoma

>Placental Site Trophoblastic Tumour (PSTT)

>Epitheliod Trophoblastic Tumour (ETT)

Epidemiology:

GTD is more common in women older than 40 years and younger than 20.

Pathogenesis:

A common characteristic of all GTD is an abnormal proliferation of trophoblast, but different components predominate in different tumours.

Diagnosis:

Clinical diagnosis presents in many ways and includes the following;

>Uterus larger than dates

>Abnormally high beta HCG

>Hyperemesis

>Hyperemesis

>Hypertension

>Theca Lutein Cysts

Although ultrasound (US) is the examination of choice for initial diagnosis, plain radiography, angiography, computed tomography (CT), and magnetic resonance (MR) imaging all play a role in determining the presence of GTD and the extent of its complications. US shows molar gestations as alternating cystic and solid tissue that fills the entire uterus. CT and MR imaging are useful in detecting myometrial invasion, parametrial extension, and metastasis. Because each imaging technique offers a unique perspective highlighting different aspects of GTD, it is important to understand the pathophysiology and natural history of the disease. Such knowledge in turn leads to a greater understanding of the spectrum of findings seen on various kinds of radiologic images and enables the radiologist to play an important role in directing patient work-up by recognizing the implications of various findings and guiding management decisions.