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Acta Obstet Gynecol Scand 2019 Apr 18. Epub 2019 Apr 18.

University of Milan, Milano, Lombardia, Italy.

Whatever the outcome, pregnancy provides the opportunity to offer effective contraception to couples motivated to avoid another pregnancy. This narrative review summarises the evidence for health providers, drawing attention to current guidelines, on which contraceptive methods can be used, and when they should be started after pregnancy, whatever its outcome. Fertility returns within one month of the end of pregnancy unless breastfeeding occurs. Read More

F1000Res 2019 10;8. Epub 2019 Apr 10.

Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

Gestational trophoblastic disease or neoplasia covers a spectrum of benign and malignant conditions arising from pregnancies with highly abnormal development of trophoblastic tissue. In this brief review, we discuss the different features of these different conditions and their origins and risk factors and introduce some of the more novel and controversial treatment options currently being explored. Read More

J Cancer Surviv 2019 Apr 17. Epub 2019 Apr 17.

Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, 2031, Australia.

Purpose: Fertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.

Methods: Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy. Read More

Obstet Gynecol 2019 Apr 5. Epub 2019 Apr 5.

Departments of Obstetrics and Gynaecology, Community Medicine, Pathology, and Oncology, Mansoura University, Mansoura, Egypt; and the Departments of Surgery and Gynecologic Oncology, Erasmus MC Cancer Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Objective: To investigate the effect of second uterine curettage on the number of chemotherapy courses and relapse rate in low-risk postmolar gestational trophoblastic neoplasia.

Methods: In a phase III trial, patients with low risk gestational trophoblastic neoplasia were randomised (1:1) to a second curettage or no curettage group before methotrexate treatment. Eligibility criteria were serum human chorionic gonadotropin (hCG) level 5,000 international units/L or less and fit for treatment with methotrexate. Read More

Mod Pathol 2019 Apr 5. Epub 2019 Apr 5.

Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.

Uniparental disomy is an abnormal genetic condition in which both homologous chromosomes or part of the chromosome are inherited from one parent and the other parent's homologous chromosome is lost. We report three cases of gestations with paternal uniparental isodisomy at tyrosine hydroxylase or TH01 locus on chromosome 11p15.4 identified by DNA genotyping. Read More

Ginekol Pol 2019 ;90(3):141-147

Department of Gynecology, Obstetrics and Gynecologic Oncology, Division of Gynecologic Oncology, Poznan University of Medical Sciences, Poznan, Poland.

Objectives: The early identification of patients who are being treated for low-risk gestational trophoblastic neoplasia (LRGTN) with single-agent chemotherapy, who are at high risk of developing chemoresistance, is of crucial importance. The aim of our research was to evaluate the pretreatment beta subunit of human chorionic gonadotropin (βhCG) concentration and its decrease after the administration of the first course of methotrexate (MTX) in predicting later chemo-resistance to single-agent chemotherapy.

Material And Methods: A total of 46 patients diagnosed with LRGTN treated with a 5-day methotrexate (MTX) regimen were retrospectively studied. Read More

Bull Cancer 2019 Apr 21;106(4):328-341. Epub 2019 Mar 21.

Hôpital Foch, service d'anatomie et cytologie pathologiques, 40, rue Worth, 92150 Suresnes, France; Institut Curie, service de pathologie, 35, rue Dailly, 92240 Saint Cloud, France. Electronic address:

In 2016, the WHO classification of testicular germ cell tumors was revised considering advances in the understanding of their tumorigenesis and molecular features. This restructuring led to a division into two major groups with, on one hand, prepubertal-type tumors, not derived from germ cell neoplasia in situ (GCNIS), and on the other hand, postpubertal-type tumors, GCNIS-derived, which occur in youg men (seminoma and non seminomatous germ cell tumors - embryonal carcinoma, yolk sac tumor, teratoma and choriocarcinoma essentially). The term germ cell neoplasia in situ is consensually accepted as a new terminology for the precursor lesion. Read More

Oncol Lett 2019 Mar 9;17(3):2576-2582. Epub 2019 Jan 9.

Laboratory of Biochemistry and Immunology, College of Veterinary Medicine, Chungbuk National University, Cheongju, North Chungcheong 28644, Republic of Korea.

Gestational trophoblastic disease (GTD) is an unusual disease occurring in pregnancy that originates from abnormal trophoblastic cells and comprises a group of diseases with different properties of invasion, metastasis and recurrence. The GTD group includes hydatidiform moles and gestational trophoblastic neoplasms (GTNs), with GTNs being divided into invasive moles, choriocarcinoma, placental site trophoblastic tumors and epithelioid trophoblastic tumors. The present review focuses on current effective treatments for GTD, including conventional and novel promising direct enzyme prodrug therapies (DEPTs). Read More

Gynecol Oncol 2019 Mar 8. Epub 2019 Mar 8.

New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Objective: To evaluate the impact of periodic shortage of actinomycin-d (Act-d) in the treatment of Brazilian patients with low-risk gestational trophoblastic neoplasia (GTN) after methotrexate and folinic acid rescue (MTX/FA) resistance, treated alternately with carboplatin or etoposide as a second-line regimen.

Methods: Retrospective cohort that included patients with failure of first-line MTX/FA regimen for low-risk GTN treated at Rio de Janeiro Federal University, Universidade Federal de São Paulo and Irmandade da Santa Casa de Misericórdia de Porto Alegre, from January/2010- December/2017.

Results: From 356 patients with low-risk GTN treated with MTX/FA, 75 (21. Read More

Virchows Arch 2019 Mar 8. Epub 2019 Mar 8.

Department of Pathology, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.

Although epithelial-to-mesenchymal transition (EMT) has been described in the development of complete hydatidiform moles and the invasion of the maternal decidua by trophoblasts during normal human placentation, its implication in gestational trophoblastic neoplasm (GTN) without villi is totally unknown. We studied the immunoexpression of EMT transcription factors (TWIST1, ZEB1, ZEB2), E-cadherin, and vimentin in 18 trophoblastic tumors and pseudo-tumors. Weak nuclear TWIST1 immunostaining was seen in 5% to 10% of all trophoblastic cells, without ZEB1 and ZEB2 nuclear staining. Read More

Placenta 2019 Feb 5;77:58-64. Epub 2019 Feb 5.

Placental Related Disease Research Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand. Electronic address:

Introduction: Protein expression in cells are associated with oncogenesis. This study aims to explore proteomic profiles and discover potential biomarkers that can predict malignant transformation of hydatidiform mole.

Methods: Retrospective analysis was done in 14 cases of remission hydatidiform mole and 14 cases of hydatidiform mole who later developed malignancy (GTN group). Read More

World J Clin Oncol 2019 Feb;10(2):28-37

Department of Medical Oncology, Charing Cross Gestational Trophoblastic Disease Centre, Charing Cross Hospital, Imperial College London, London W6 8RF, United Kingdom.

Gestational trophoblastic neoplasia (GTN) is a rare tumor that originates from pregnancy that includes invasive mole, choriocarcinoma (CCA), placental site trophoblastic tumor and epithelioid trophoblastic tumor (PSTT/ETT). GTN presents different degrees of proliferation, invasion and dissemination, but, if treated in reference centers, has high cure rates, even in multi-metastatic cases. The diagnosis of GTN following a hydatidiform molar pregnancy is made according to the International Federation of Gynecology and Obstetrics (FIGO) 2000 criteria: four or more plateaued human chorionic gonadotropin (hCG) concentrations over three weeks; rise in hCG for three consecutive weekly measurements over at least a period of 2 weeks or more; and an elevated but falling hCG concentrations six or more months after molar evacuation. Read More

PeerJ 2019 20;7:e6490. Epub 2019 Feb 20.

Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University Hospital, Jinju, Republic of Korea.

Introduction: We investigated the rate and longitudinal trends of gestational trophoblastic disease (GTD) incidence in the Republic of Korea between 2009 and 2015 using population-based data.

Materials And Methods: Data of patients diagnosed with GTD from 2009 to 2015 were obtained from the Health Insurance Review and Assessment Service/National Inpatient Sample (HIRA-NIS) in the Republic of Korea. The HIRA annually provides the HIRA-NIS, a collection of clinical data from over one million people. Read More

Br J Cancer 2019 Mar 22;120(6):587-594. Epub 2019 Feb 22.

Department of Medical Oncology, Charing Cross Gestational Trophoblastic Disease Centre, Imperial College NHS Healthcare Trust and Imperial College London, London, UK.

Background: Placental-site trophoblastic (PSTT) and epithelioid trophoblastic tumours (ETT) are the rarest malignant forms of gestational trophoblastic disease (GTD). Our prior work demonstrated that an interval of ≥48 months from the antecedent pregnancy was associated with 100% death rate, independent of the stage. Here, we assess whether modified treatments for these patients have increased survival and identify new prognostic factors. Read More

Int J Hematol Oncol Stem Cell Res 2018 Oct;12(4):291-297

Department of Obstetrics and Gynecology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The present study was conducted to determine the response to treatment in patients with GTN, the survival rate and to investigate the outcomes of first pregnancy after chemotherapy. The treatment protocol was based on the FIGO Staging of GTN and the Modified WHO Prognostic Scoring. Complete remission was achieved with MTX in 100% of the low-risk patients and with combination therapy in 91% of the high-risk cases. Read More

Placenta 2019 Feb 12. Epub 2019 Feb 12.

Mother Infant Research Institute, Tufts Medical Center, Boston, MA, USA. Electronic address:

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2018 there were nine themed workshops, five of which are summarised in this report. These workshops discussed new perspectives and knowledge in the following areas of research: 1) preeclampsia; 2) abnormally invasive placenta; 3) placental infection; 4) gestational trophoblastic disease; 4) drug delivery to treat placental dysfunction. Read More

Metabolites 2019 Feb 9;9(2). Epub 2019 Feb 9.

Gynecologic Oncology Department, Poznan University of Medical Sciences, Polna 33, 60-535 Poznan, Poland.

Gestational trophoblastic disease (GTD) is a group of highly aggressive, rare tumors. Human chorionic gonadotropin is a common biomarker used in the diagnosis and monitoring of GTD. To improve our knowledge of the pathology of GTD, we performed protein-peptide profiling on the urine of patients affected with gestational trophoblastic neoplasm (GTN). Read More

J Gynecol Oncol 2019 Mar 23;30(2):e16. Epub 2018 Nov 23.

Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Objective: To investigate the significance of lung nodule in hydatidiform mole, we retrospectively compared the clinical outcomes of those patients treated with different strategies.

Methods: The patients were divided into three groups: chemotherapy immediately once lung nodule was detected (group 1, n=17), delayed chemotherapy until human chorionic gonadotrophin (hCG) level met the diagnostic criteria for gestational trophoblastic neoplasia (GTN) (group 2, n=18), and hCG surveillance alone until hCG level was normalized spontaneously (group 3, n=18). The clinical parameters of these patients were collected and analyzed. Read More

Eur J Cancer 2019 Mar 4;109:162-171. Epub 2019 Feb 4.

Department of Medical Oncology, Charing Cross Hospital Campus of Imperial College, London, UK. Electronic address:

Objective: The objective of the study was to evaluate the effect of high-dose chemotherapy (HDC) with peripheral blood stem cell support (PBSCS) on survival of patients with gestational trophoblastic neoplasia (GTN) with either refractory choriocarcinomas or a poor-prognosis placental site/epithelioid trophoblastic tumours (PSTT/ETTs).

Methods: Databases of two referral centres for gestational trophoblastic disease were searched, and 32 patients treated with HDC between 1994 and 2015 were identified. Tissue samples were retrieved for genetic evaluation. Read More

Eur Respir Rev 2019 Mar 6;28(151). Epub 2019 Feb 6.

National Pulmonary Hypertension Service, Royal Brompton Hospital, Imperial College London, London, UK.

Tumoral pulmonary hypertension (PH) comprises a variety of subtypes in patients with a current or previous malignancy. Tumoral PH principally includes the tumour-related pulmonary microvascular conditions pulmonary tumour microembolism and pulmonary tumour thrombotic microangiopathy. These inter-related conditions are frequently found in specimens but are notoriously difficult to diagnose The outlook for patients remains extremely poor although there is some emerging evidence that pulmonary vasodilators and anti-inflammatory approaches may improve survival. Read More

Indian J Pathol Microbiol 2019 Jan-Mar;62(1):142-145

Department of Pathology and Laboratory Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia.

One of the very rare forms of gestational neoplastic diseases is the malignant placental site trophoblastic tumor. Due to its rarity, the data regarding its diagnosis and management are limited. The prognosis of this tumor is unpredictable with potential malignant behavior and metastasis. Read More

Indian J Pathol Microbiol 2019 Jan-Mar;62(1):54-60

Department of Pathology, S.C.B. Medical Colllege, Cuttack, Odisha, India.

Background: Gestational trophoblastic disease (GTD) constitutes a spectrum of tumors and tumor-like conditions, characterized by proliferation of pregnancy-associated trophoblastic tissue of progressive malignant potential. It is very difficult to differentiate these complex groups of lesions basing on histomorphology alone. Immunohistochemistry (IHC) with cyclin E, P63, and Ki-67 has a definite role in the identification of different trophoblasts and entities of GTD and also in the determination of biological behavior. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14010

Department of Obstetrics and Gynecology.

Rationale: Extrauterine epithelioid trophoblastic tumors (ETT) is a rare variant of gestational trophoblastic neoplasms. Here we aim to learn more clinical and pathological characteristics of ETT patient with an isolated pulmonary mass without uterine lesions, through a rare case of extra-uterine ETT and 7 cases published in English periodicals literature.

Patient Concerns: A 31-year-old Chinese woman, presented with low-level elevation of serum human chorionic gonadotropin (HCG) for more than 2 years without abnormal symptoms. Read More

Int J Gynecol Cancer 2019 Mar 29;29(3):547-553. Epub 2019 Jan 29.

Department of Gynaecologic Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.

Objectives: To assess the importance of salvage therapy in the management of high-risk gestational trophoblastic neoplasia (HR GTN) after failure of first line multiagent chemotherapy.

Methods: This retrospective study involving women with HR GTN treated at Kidwai cancer institute from 2000 to 2015. Initial chemotherapy consisted of etoposide, methotrexate with folinic acid, actinomycin D, cyclophosphamide and vincristine (EMA-CO). Read More

Eur J Obstet Gynecol Reprod Biol 2019 Mar 6;234:117-119. Epub 2019 Jan 6.

Trophoblastic Disease Centre, Charing Cross Hospital, London, UK.

Objective: To determine whether post-pregnancy human chorionic gonadotrophin screening after previous hydatidiform mole identifies patients with recurrent gestational trophoblastic disease.

Study Design: A retrospective evaluation of 9315 patients who underwent post-pregnancy screening from 2000 to 2009, as part of the National Gestational Trophoblastic Disease Service in the UK.

Results: Patients with previous hydatidiform mole, who had human chorionic gonadotrophin screening after one or more subsequent pregnancies, were identified (n = 9315). Read More

JSLS 2019 Jan-Mar;23(1)

Department of Anesthesiology and Pain Medicine, Uijeongbu St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.

Introduction: Uterine-conservative surgery via laparoscopy is a challengeable and high risk because of heavy intra-operative bleeding events in reproductive women with highly vascular uterine benign disease. There are three reported cases of women with highly vascular uterine benign diseases and high risk of intra-operative heavy bleeding, but were treated successfully to control intra-operative heavy bleeding risk by transient occlusion of the uterine artery (TOUA) through laparoscopy and resulted in safe conservation of the uterus.

Case Presentation: The cases of women with high risk of heavy bleeding during therapeutic procedure included cesarean scar pregnancy, hydatid form mole on cesarean scar, and cervical pregnancy. Read More

J Cancer 2019 1;10(1):11-19. Epub 2019 Jan 1.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, PR China.

Epithelioid trophoblastic tumors (ETTs) are the rarest type of gestational trophoblastic neoplasias. We investigated the clinical features, treatments, outcomes, and prognostic factors in patients with ETT, and explored potential therapeutic targets. We retrospectively analyzed the clinical features, treatments, survival, and prognostic factors of 21 ETT patients treated at our institution between January 2002 and December 2017. Read More

Hum Reprod Update 2019 May;25(3):326-343

Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology and Key Laboratory of Assisted Reproduction, Department of Obstetrics and Gynecology, Ministry of Education, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China.

Background: Initially identified as suppressors of metastasis in various types of cancer, kisspeptins are a family of neuropeptides that are key regulators of the mammalian reproductive axis. Accumulating evidence has shown that kisspeptin is able to control both the pulsatile and surge GnRH release, playing fundamental roles in female reproduction, which include the secretion of gonadotropins, puberty onset, brain sex differentiation, ovulation and the metabolic regulation of fertility. Furthermore, recent studies have demonstrated the involvement of the kisspeptin system in the processes of implantation and placentation. Read More

Int J Gynecol Cancer 2019 Jan;29(1):108-112

Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, The Netherlands.

Objectives: Because gestational trophoblastic disease is rare, little evidence is available from randomized controlled trials on optimal treatment and follow-up. Treatment protocols vary within Europe, and even between different centers within countries. One of the goals of the European Organization for Treatment of Trophoblastic Diseases (EOTTD) is to harmonize treatment in Europe. Read More

Expert Rev Mol Diagn 2019 02 29;19(2):175-188. Epub 2019 Jan 29.

a Department of Pathology , Yale University School of Medicine , New Haven , CT , USA.

Introduction: Among various human tissue identity testing platforms, short tandem repeat (STR) genotyping has emerged as the most powerful and cost-effective method. Beyond forensic applications, tissue identity testing has become increasingly important in modern medical practice, in areas such as diagnostic pathology. Areas covered: A brief overview of various molecular/genetic techniques for identity testing is provided. Read More

Ginekol Pol 2018 ;89(12):711-715

The Chair and Clinic of Obstetrics, Gynaecologic Diseases and Oncological Gynaecology of the Second Faculty of Medicine of Warsaw Medical University, Poland.

Choriocarcinoma is one of rare neoplasms of female reproductive organs. In the last decade only a few cases of this disease have been registered in Poland. The paper presents the current principles of diagnosis and treatment options for this rare disease based on the authors' clinical experience (description of the case) and literature review. Read More

BMC Cancer 2019 Jan 7;19(1):13. Epub 2019 Jan 7.

Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, No.1 Xueshi Road, Hangzhou, 310006, Zhejiang Province, China.

Background: The clinical value of total hysterectomy for patients with hydatidiform mole (HM) being at least 40 years old remains highly controversial. Since the practice of hysterectomy has been applied globally for decades, there is an urgent need to perform a systematic review to assess its risks and benefits.

Methods: Six electronic databases, including four English databases and one Chinese database, were searched from the inception of each database till October 6th 2017. Read More

Wellcome Open Res 2016 6;1:32. Epub 2018 Dec 6.

Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, Thailand.

No universal  demarcation of gestational age  distinguishes miscarriage and stillbirth or extreme preterm birth (exPTB). This study provides a synopsis of outcome between 22 to <28 weeks gestation from a low resource setting. A retrospective record review of a population on the Thailand-Myanmar border was conducted. Read More

J Assist Reprod Genet 2019 Jan 5. Epub 2019 Jan 5.

Department of Reproductive Medicine, Saint Mary's Hospital, Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.

Introduction: The use of assisted reproduction techniques (ART) is increasing; however, reports of molar pregnancy following ART remain scarce. Currently, the Human Fertility and Embryology Authority (HFEA) collates data on the molar pregnancies that have resulted through the use of ART. Recently, they have indicated that they will no longer collect these data. Read More

Zhonghua Yi Xue Za Zhi 2018 Dec;98(47):3896-3899

Department of Obstetrics and Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

This study aims to evaluate the efficacy of EMA-CO as an initial regimen for high-risk gestational trophoblastic neoplasia and to analysis the influenced factors. A total of 81 patients with high-risk gestational trophoblastic neoplasia (HRGTN) treated in Women Hospital Affiliated Zhejiang University from Jan 2007 to Jan 2017 whose primary chemotherapies were EMA-CO were enrolled.The International Federation of Gynecology and Obstetrics (FIGO) prognosis score of all the patients was ≥7. Read More

Arch Gynecol Obstet 2019 Apr 19;299(4):1115-1119. Epub 2018 Dec 19.

Department of Gynecology and Obstetrics, Ruhr University Bochum, Herne, Germany.

Background And Purpose: Choriocarcinoma (CCA) is a rare form of malignant trophoblastic disease. Systemic polychemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA/CO) is the mainstay of treatment for metastatic disease. Due to the rarity of the condition, however, the evidence basis for this management is small and other chemotherapy regimens may also be effective. Read More

Nuklearmedizin 2018 Dec 18;57(6):N57. Epub 2018 Dec 18.

Pathol Res Pract 2019 Mar 12;215(3):446-452. Epub 2018 Dec 12.

Pathology Department, Farhet Hached Hospital, 4000 Sousse, Tunisia; Medicine Faculty of Sousse, University of Sousse, 4000 Sousse, Tunisia.

Hydatidiform moles (HM) are characterized by an abnormal proliferating trophoblast with a potential for a malignant transformation. Similar to other human tumors, trophoblastic pathogenesis is likely a multistep process involving several molecular and genetic alterations. The study was performed to investigate the expression patterns of c-erbB-2 and Bcl-2 oncoproteins, p53, p21 and p63 tumor suppressor proteins and Ki-67 cell proliferation marker in HM. Read More

Twin Res Hum Genet 2018 12 7;21(6):563-569. Epub 2018 Dec 7.

Department of Psychology,California State University,Fullerton,California,USA.

Twin research has found genetic influence underlying vocational interests, work values, and job satisfaction. In addition, numerous studies have shown that monozygotic (MZ) twins generally display greater within-pair cooperation and social closeness than dizygotic (DZ) twins. These findings are illuminated by exploring the occupational histories of two female twin pairs, one set MZ and the other set DZ. Read More

Gynecol Oncol Rep 2018 Nov 31;26:102-104. Epub 2018 Oct 31.

Division of Gynecologic Oncology, The University of Iowa Hospitals and Clinics, United States.

When elevated serum hCG is discovered during the work up of a gynecologic tumor, it is paramount to identify the source of hCG prior to initiation of treatment. Potential sources of hCG include viable intrauterine pregnancy, ectopic pregnancy, miscarriage, gestational trophoblastic disease, pituitary hCG production, phantom hCG (heterophilic antibody interference), and tumor production. Here, we present a case of elevated hCG in a young women with a large complex pelvic mass. Read More

Obstet Gynecol 2019 Jan;133(1):163-166

Departments of Obstetrics and Gynecology and Pathology, Tufts Medical Center, Boston, Massachusetts.

Background: Gestational trophoblastic neoplasia rarely occurs in term pregnancies. Stage IV choriocarcinoma treated with conventional chemotherapy can result in death as a result of hemorrhagic sequelae at tumor sites.

Case: A 30-year-old woman at 34 weeks of gestation presented with a persistent cough, worsening dyspnea, and vaginal bleeding. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13439

Interdisciplinary Department of Medicine, Gynecology and Obstetrics Clinic, University of Bari.

Rationale: Placental site trophoblastic tumor (PSTT) is a very rare malignant tumor, belonging to a family of pregnancy-related illnesses, called gestational trophoblastic diseases (GTD). Less than 300 cases of PSTT have been reported in literature, with an incidence of ≈ 1/50,000-100,000 pregnancies representing only 0.23% to 3. Read More

Arch Pathol Lab Med 2018 Dec;142(12):1485-1502

From the Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.

Context.—: Distinction of hydatidiform moles from nonmolar specimens and subclassification of hydatidiform moles as complete hydatidiform mole versus partial hydatidiform mole are important for clinical practice and investigational studies. Risk of persistent gestational trophoblastic disease and clinical management differ for these entities. Read More

Gynecol Oncol 2019 02 22;152(2):361-367. Epub 2018 Nov 22.

Department of Medical Oncology, Charing Cross Hospital, London, United Kingdom.

Objective: Epithelioid Trophoblastic Tumor (ETT) is an extremely rare form of Gestational Trophoblastic Neoplasia (GTN). Knowledge on prognostic factors and optimal management is limited. We identified prognostic factors, optimal treatment, and outcome from the world's largest case series of patients with ETT. Read More

J Int Med Res 2019 Feb 9;47(2):673-681. Epub 2018 Nov 9.

1 Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Objective: This study aimed to determine the diagnostic value of magnetic resonance imaging (MRI), hysteroscopy, and laparoscopy to avoid unnecessary treatment when patients present with clinical manifestations that are close to those of gestational trophoblastic neoplasia (GTN).

Methods: Three patients who were falsely diagnosed with presumed GTN and received needless chemotherapy in our hospital from July 2011 to March 2012 were studied. We also reviewed data of patients with similar clinical features who were diagnosed as having residual pregnancy in recent years. Read More

Arch Pathol Lab Med 2019 Jan 8;143(1):65-74. Epub 2018 Nov 8.

From the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.

Context.—: Gestational trophoblastic tumors include 3 distinct entities: gestational choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Accurate diagnosis is important for clinical management of the patient. Read More

Oncol Lett 2018 Nov 20;16(5):6458-6464. Epub 2018 Sep 20.

Jiangxi Provincial Key Laboratory of Reproductive Physiology and Pathology, Department of Physiology, School of Medicine, Nanchang University, Nanchang, Jiangxi 330006, P.R. China.

Uterine natural killer (uNK) cells have been hypothesized to serve a role in controlling trophoblast invasion and proliferation. The aim of the present study was to identify the distribution and number of uNK cells in normal pregnancy (NP), partial mole (PM), complete mole (CM) and invasive mole (IM). uNK cells were detected using dolichos biflorus agglutinin lectin immunohistochemistry in decidual and villous tissues from early NP (n=15), late NP (n=15), PM (n=22), CM (n=20) and IM (n=10). Read More

Cell Physiol Biochem 2018 5;50(5):1815-1831. Epub 2018 Nov 5.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an,

Background/aims: Choriocarcinoma (CC) is a highly aggressive gestational trophoblastic neoplasia; however, the underlying molecular mechanisms of its invasiveness and metastasis remain poorly understood. Human secreted frizzled-related protein 2 (SFRP2) could function as a tumor promoter or suppressor in different tumors, yet the role it plays in CC's invasion and metastasis is thoroughly unclear. The current study was aimed to explore the function and underlying mechanism of SFRP2 in CC. Read More

Int J Gynecol Cancer 2018 11;28(9):1766-1771

Pôle Information Médicale Evaluation Recherche, Equipe d'Accueil 4129, Hospices Civils de Lyon, Lyon.

Objective: This study aimed to assess the outcome of first-line hysterectomy in patients diagnosed as having gestational trophoblastic neoplasia (GTN) whose postoperative imaging showed lung images considered as metastases.

Methods: From 1999 to 2016, patients no longer wishing to conceive, treated by their initial physician by hysterectomy, and whose postoperative imaging workup showed lung images considered as metastasis were identified in the French Trophoblastic Disease Reference Center database. We sought to identify significant predictive factors of requiring salvage chemotherapy. Read More