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Rev Bras Ginecol Obstet 2022 Jun 27. Epub 2022 Jun 27.

Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, New England Trophoblastic Disease Centre, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States.

Objective:  There are few multinational studies on gestational trophoblastic neoplasia (GTN) treatment outcomes in South America. The purpose of this study was to assess the clinical presentation, treatment outcomes, and factors associated with chemoresistance in low-risk postmolar GTN treated with first-line single-agent chemotherapy in three South American centers.

Methods:  Multicentric, historical cohort study including women with International Federation of Gynecology and Obstetrics (FIGO)-staged low-risk postmolar GTN attending centers in Argentina, Brazil, and Colombia between 1990 and 2014. Read More

J Pak Med Assoc 2022 Jun;72(6):1260-1262

Department of Surgery, Aga Khan University, Karachi, Pakistan.

A 34-year-old woman had a history of 3 miscarriages and presented with symptoms of an unproductive cough and rising serum beta-human chorionic gonadotropin (b-hCG) levels. There were no gynaecological symptoms. A diagnosis of Choriocarcinoma with pulmonary metastasis was made. Read More

Int J Surg Case Rep 2022 Jun 18;96:107320. Epub 2022 Jun 18.

Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.

Introduction And Importance: Here, we discuss novel management with methotrexate for the rare case of a complete hydatidiform mole with a co-existing fetus (CHMCF). The management of CHMCF is controversial, and methotrexate might represent a solution. CHMCF management with methotrexate needs more study, especially its side effects, safe dosage, and the permissible period of pregnancy. Read More

Am J Case Rep 2022 Jun 18;23:e936451. Epub 2022 Jun 18.

Department of Internal Medicine, of Illinois College of Medicine at Peoria, Peoria, IL, USA.

BACKGROUND Despite the tendency to metastasize widely, Gestational Trophoblastic Neoplasia (GTN) is one of the most curable solid tumors with chemotherapy. CASE REPORT A 41-year-old female, G4P2A2, presented with a slowly growing lump on the left side of the scalp associated with a headache. The patient had intermittent, sharp left eye pain which radiated to the side of her face, photophobia, early morning blurring of vision, and nausea. Read More

Surg Pathol Clin 2022 Jun 20;15(2):197-218. Epub 2022 May 20.

Department of Pathology, Yale School of Medicine, 310 Cedar Street LH 108, PO Box 208023, New Haven, CT 06520-8023, USA. Electronic address:

Pathologic diagnosis of gestational trophoblastic disease (GTD)-hydatidiform moles and gestational trophoblastic neoplasms-underwent a major shift in the past decade from morphology-based recognition to precise molecular genetic classification of entities, which also allows for prognostic stratification of molar gestations. This article highlights these recent advances and their integration into the routine pathology practice. The traditional gross and histomorphologic features of each entity are also reviewed with special focus on differential diagnoses and their clinical implications. Read More

Acta Obstet Gynecol Scand 2022 Jun 11. Epub 2022 Jun 11.

Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Introduction: Treatment with antibodies directed against programmed-cell death ligand 1 (PD-L1) is a novel therapy for patients with gestational trophoblastic disease. Assessment of PD-L1 expression in tumor tissue is commonly used to identify patients who might benefit from anti-PD-L1 treatment. Multiple antibodies are available to detect PD-L1-expressing cells, and percentages of PD-L1-expressing cells in samples of patients with gestational trophoblastic disease indicated by these antibodies differ substantially. Read More

Cancers (Basel) 2022 Jun 3;14(11). Epub 2022 Jun 3.

Unit of Gynaecology and Obstetrics, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Background: Gestational trophoblastic disease includes a rare group of benign and malignant tumors derived from abnormal trophoblastic proliferation. Malignant forms are called gestational trophoblastic neoplasia (GTN) and include invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. Standard treatment of GTN is chemotherapy. Read More

Front Oncol 2022 23;12:907045. Epub 2022 May 23.

Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background: There is no consensus for the management of epithelioid trophoblastic tumor (ETT) up to date.

Objective: ETT is the rarest form of gestational trophoblastic neplasia (GTN). Our goal was to assess the outcomes and explore the prognostic factors of patients with ETT through this multicenter retrospective analysis and to devise a risk-adapted approach to clinical management. Read More

Dis Markers 2022 24;2022:7155525. Epub 2022 May 24.

Department of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

Background: Gestational choriocarcinoma (GC) is a rare malignant gestational trophoblastic tumor. Long noncoding RNA (lncRNA) CBR3 antisense RNA 1 (CBR3-AS1) has been reported to serve as a critical oncogene and facilitate tumor progression. Besides, we found that CBR3-AS1 is implicated in GC progression. Read More

Minerva Obstet Gynecol 2022 Jun;74(3):308-313

Prenatal Medicine Unit, Service of Obstetrics and Gynecology, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy -

Molar degeneration of the trophoblast is a rare, yet possible, complication of pregnancies. Complete hydatidiform mole is the most common histological type among all trophoblastic tumors and it is the result of the fertilization of an empty oocyte from two sperms or by one sperm that then duplicates. Complete mole is characterized by hydropic degeneration of abnormal chorionic villi, diffused trophoblast hyperplasia and the absence of identifiable embryonic or fetal tissue; the hyperplastic trophoblast justifies the common finding of high serum beta HCG levels. Read More

J Turk Ger Gynecol Assoc 2022 06;23(2):83-94

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesk, India

Objective: Molar pregnancy coexistent with a live fetus can be a diagnostic and therapeutic challenge. With increasing incidence of multiple pregnancies, there has also been an increase in twin pregnancy with one mole in the recent years. The authors discuss the epidemiology, clinical presentation, and prenatal diagnosis and attempt to design a possible management strategy, to help guide the treating physician, in the management of partial mole with live pregnancy, thereby improving maternal and fetal prognosis. Read More

Eur J Obstet Gynecol Reprod Biol 2022 Jul 25;274:136-141. Epub 2022 May 25.

Department of Obstetrics and Gynecology, Galilee Medical Cente, Israel; Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.

Objective: Molar pregnancy is the most common type of gestational trophoblastic disease. Several recent reports have described changes in the clinical representation, the incidence and the diagnostic sensitivity of molar pregnancy. These changes could be due to widespread use of transvaginal ultrasound and beta-hCG testing in the management of routine first-trimester investigations. Read More

Ann Med Surg (Lond) 2022 May 21;77:103659. Epub 2022 Apr 21.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Jendral Soedirman - Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Indonesia.

Introduction: The management of a large uterine fibroid concurrent with gestational trophoblastic disease (GTD) in a nullipara is complicated, challenging yet should focus on conserving fertility. We would like to share our experience.

Case Description: A 28-year-old G1P0A0 of 10-11 weeks' gestation presented with a profuse vaginal bleeding with a history of passing swollen, grape-like tissues from the vagina. Read More

Arch Public Health 2022 May 26;80(1):146. Epub 2022 May 26.

Department of Epidemiology and Biostatistics, Institut of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Background: The standard of treatment in developing countries is harmed by a complex political landscape, an uncertain economic climate, rapid population growth, and clients are constantly complaining about the poor health system. Patients' assessments of the benefits and shortcomings of the service provided to them are expressed as satisfied or dissatisfied. The objective of this study was to determine the magnitude of women's satisfaction on quality of safe abortion and factors associated with it in Northwest Ethiopia. Read More

Taiwan J Obstet Gynecol 2022 May;61(3):453-458

Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, PR China. Electronic address:

Objective: To evaluate the obstetrical and oncological progression of twin pregnancies with hydatidiform mole coexisting fetus (HMCF).

Materials And Methods: Using a retrospective method based on patients from the Women's Hospital, Zhejiang University School of Medicine database between January 1990 and October 2020, 17 patients were histologically confirmed as having HMCF, and the patients' prenatal diagnosis, outcomes and development of gestational trophoblastic neoplasia (GTN) were reviewed.

Results: Among these 17 cases, 11 (64. Read More

BMJ Case Rep 2022 May 18;15(5). Epub 2022 May 18.

Obstetric and Gynaecology, Sarawak General Hospital, Kuching, Sarawak, Malaysia.

Gestational trophoblastic neoplasm (GTN) in end-stage renal failure (ESRF) has not been reported. We reported an unprecedented case of GTN in ESRF from an antecedent partial mole. She had total abdominal hysterectomy and bilateral salpingectomy following the diagnosis as the disease was confined to the uterus. Read More

Clin Epigenetics 2022 05 17;14(1):64. Epub 2022 May 17.

Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, 849-8501, Japan.

Background: Placental mesenchymal dysplasia (PMD) is a morphological abnormality resembling partial hydatidiform moles. It is often associated with androgenetic/biparental mosaicism (ABM) and complicated by Beckwith-Wiedemann syndrome (BWS), an imprinting disorder. These phenomena suggest an association between PMD and aberrant genomic imprinting, particularly of CDKN1C and IGF2. Read More

Gynecol Oncol Rep 2022 Jun 5;41:100994. Epub 2022 May 5.

University of California San Diego, Department of Gynecologic Oncology, San Diego, CA, USA.

We present an unusual case of a 28-year-old female who had atypical trophoblastic proliferation on her endocervical curettage (ECC) performed at the time of a colposcopy. The indication for colposcopy was a Pap smear notable for atypical squamous cells of unknown significance, positive HPV. Initially conservative management was pursued, but given persistent atypia the patient ultimately decided to proceed with definitive management via hysterectomy. Read More

Dis Markers 2022 30;2022:1495082. Epub 2022 Apr 30.

Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.

It has been established that microRNAs (miRNAs) are involved in the regulation of immune responses and serve as biomarkers of inflammatory diseases as well as recurrent spontaneous miscarriage (RSM). Herein, we aimed to study the relationship between three functional gene polymorphisms with idiopathic RSM (IRSM) susceptibility. We recruited 161 patients with IRSM and 177 healthy women with at least one live birth and without a history of abortion. Read More

Crit Rev Oncol Hematol 2022 Jun 6;174:103700. Epub 2022 May 6.

Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.

The immune checkpoint inhibitors (ICIs) entered treatment algorithms in most tumors. However, the data on the efficacy is limited in rare tumors with no phase III studies. We systemically reviewed the clinical trials evaluating the ICI efficacy in rare tumors and included a total of 47 clinical trials in this review. Read More

BMC Cancer 2022 May 6;22(1):509. Epub 2022 May 6.

Department of Gynecologic Oncology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, 310006, China.

Background: To investigate the clinicopathological characteristics, diagnoses, treatments, and outcomes of a special type of gestational trophoblastic neoplasia (GTN) which only has extrauterine metastases without uterine primary lesions.

Methods: The medical records and pathological sections of the patients who were pathologically diagnosed as GTN, only had extrauterine metastatic lesions but lacked uterine primary lesions, in Women's Hospital of Zhejiang University School of Medicine from February 2014 to March 2021 were collected and reviewed.

Results: Thirteen patients with pathologically confirmed GTN presenting with extrauterine metastases from a missing primary site were included in the past 7 years. Read More

Cureus 2022 Apr 1;14(4):e23747. Epub 2022 Apr 1.

Internal Medicine, University at Buffalo, Buffalo, USA.

Elevated beta-human chorionic gonadotropin (beta-hCG) levels in postmenopausal women is a finding known in the literature; however, it still commonly leads to unnecessary and extensive diagnostic workup. We present the case of a 48-year-old African-American postmenopausal female with acute kidney injury on chronic kidney disease (CKD) stage 5 and an incidental finding of elevated serum beta-hCG. Abdominal and transvaginal ultrasound showed no evidence of intrauterine or ectopic pregnancy or gestational trophoblastic disease. Read More

Curr Treat Options Oncol 2022 Jul 5;23(7):1035-1043. Epub 2022 May 5.

Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Toronto, 610 University Ave, Toronto, ON, M5G2M9, Canada.

Opinion Statement: Most individuals with gestational trophoblastic neoplasia (GTN) are cured with chemotherapy; however, about 5% of them will develop chemotherapy-resistant disease and will die of disease progression. Most GTN tissues express programmed death ligand-1 (PDL-1), making immune checkpoint inhibitors (ICIs) targeting this pathway an attractive treatment option for individuals with GTN. There is increasing evidence to support the use of ICIs for individuals with recurrent or resistant GTN, but available data are derived from case reports and small single arm trials. Read More

Front Oncol 2022 13;12:859071. Epub 2022 Apr 13.

Division of Gynecology and Obstetrics 1, "City of Health and Science University Hospital", University of Turin, Turin, Italy.

In this review, we provide the state of the art about brain metastases (BMs) from gestational trophoblastic neoplasia (GTN), a rare condition. Data concerning the epidemiology, clinical presentation, innovations in therapeutic modalities, and outcomes of GTN BMs are comprehensively presented with particular attention to the role of radiotherapy, neurosurgery, and the most recent chemotherapy regimens. Good response rates have been achieved thanks to multi-agent chemotherapy, but brain involvement by GTNs entails significant risks for patients' health since sudden and extensive intracranial hemorrhages are possible. Read More

Int J Gynecol Cancer 2022 Apr 29. Epub 2022 Apr 29.

Gynecology and Obstetrics, University of Liege Central University Hospital, Liège, Belgium

Objective: To evaluate the added value of a centralized pathology review of the diagnoses of gestational trophoblastic diseases by expert pathologists and its potential impact on clinical management in a prospective multicenter study based on the Belgian Gestational Trophoblastic Diseases Registry.

Methods: From July 2012 to December 2020, the two referral centers of the registry were solicited to advise on 1119 cases. Referral pathologists systematically reviewed all of the initial histological diagnoses. Read More

J Med Cases 2022 Apr 25;13(4):151-154. Epub 2022 Mar 25.

Anesthesia and Perioperative Medicine, Obstetric Anesthesia, Medical University of South Carolina, Charleston, SC 29425, USA.

Choriocarcinoma in a viable pregnancy is uncommon. The diagnosis can easily be missed when there is an explanation for the clinical symptoms that the cancer can mimic. We present the case of a primigravid patient whose choriocarcinoma was initially missed as a result of seemingly obvious explanations for her atypical history and disease manifestation. Read More

Br J Cancer 2022 Apr 22. Epub 2022 Apr 22.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Background: Guidelines recommend etoposide, methotrexate, actinomycin D (EMA)/cyclophosphamide, vincristine (CO) as first-line treatment for high-risk gestational trophoblastic neoplasia (GTN). However, the floxuridine, actinomycin D, etoposide and vincristine (FAEV) regimen is commonly used to treat these patients in China. We conducted a randomised controlled trial to compare the efficacies and toxicities of FAEV and EMA/CO. Read More

Cancers (Basel) 2022 Apr 13;14(8). Epub 2022 Apr 13.

Department of Medical Oncology, Clínica Universidad de Navarra, 28027 Madrid, Spain.

Patient registries linked to biorepositories constitute a valuable asset for clinical and translational research in oncology. The Spanish Group of Ovarian Cancer Research (GEICO), in collaboration with the Spanish Biobank Network (RNBB), has developed a multicentre, multistakeholder, prospective virtual clinical registry (VCR) associated with biobanks for the collection of real-world data and biological samples of gynaecological cancer patients. This collaborative project aims to promote research by providing broad access to high-quality clinical data and biospecimens for future research according to the needs of investigators and to increase diagnostic and therapeutic opportunities for gynaecological cancer patients in Spain. Read More

Diagnostics (Basel) 2022 Apr 5;12(4). Epub 2022 Apr 5.

Department of Mother and Child Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iaşi, Romania.

Placenta accreta spectrum disorder (PAS) has an increased frequency due to the high number of cesarean sections. The abnormal placentation associated with a retained placenta can cause persistent uterine bleeding, with ultrasound Doppler examination being the main choice to assess the uterine hemorrhage. An acquired uterine arteriovenous malformation (AVM) may occur because of uterine trauma, spontaneous abortion, dilation and curettage, endometrial carcinoma or gestational trophoblastic disease. Read More

Curr Cardiol Rev 2022 Apr 15. Epub 2022 Apr 15.

Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto.

Endothelial dysfunction, impaired implantation and placental insufficiency have been identified as mechanisms behind the development of pre-eclampsia, resulting in angiogenic factors' alteration. Angiogenic imbalance is also associated with congenital heart defects, and this common physiologic pathway may explain the association between them and pre-eclampsia. This review aims to understand the physiology shared by these two entities and whether women with pre-eclampsia have an increased risk of fetal congenital heart defects (or the opposite). Read More