Gestational Trophoblastic Disease

Gestational trophoblastic disease is a spectrum of abnormal proliferations of the placental trophoblast encompassing four main clinicopathologic forms: hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, and placental site trophoblastic tumor and its related epithelioid trophoblastic tumor. The latter three conditions are collectively referred to as gestational trophoblastic neoplasia and have varying degrees of malignant potential. Early detection of hydatidiform moles with ultrasonography, advances in uterine evacuation techniques, the use of human chorionic gonadotropin as a disease-specific tumor marker, and the introduction of chemotherapy into the management of gestational trophoblastic neoplasia has significantly decreased the risk of death from gestational trophoblastic disease. This chapter will describe the epidemiology, pathology, clinical presentation and diagnosis of each of these trophoblastic disease variants.