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Rev Bras Ginecol Obstet 2021 Apr 12;43(4):323-328. Epub 2021 May 12.

Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Complete hydatidiform mole (CHM) is a rare type of pregnancy, in which 15 to 20% of the cases may develop into gestational trophoblastic neoplasia (GTN). The diagnostic of GTN must be done as early as possible through weekly surveillance of serum hCG after uterine evacuation. We report the case of 23-year-old primigravida, with CHM but without surveillance of hCG after uterine evacuation. Read More

Am J Case Rep 2021 May 11;22:e930789. Epub 2021 May 11.

Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University - Dr. Hasan Sadikin Hospital, Bandung, Indonesia.

BACKGROUND Gestational trophoblastic disease (GTD) encompasses a group of disorders that arise from abnormal growth of trophoblastic tissue. The spectrum of GTD includes 2 major groups: benign and malignant. The benign form is a hydatidiform mole, either complete or partial; the malignant forms, referred to as gestational trophoblastic neoplasia (GTN), consist of invasive moles, choriocarcinomas, placental site trophoblastic tumors, and epithelioid trophoblastic tumors. Read More

Diagn Cytopathol 2021 May 7. Epub 2021 May 7.

Department of Histopathology, The Indus Hospital, Karachi, Pakistan.

Exfoliated trophoblastic cells can be seen in a cervicovaginal smear in cases of normal pregnancy or gestational trophoblastic disease (GTD) and can mimic high-grade squamous intraepithelial lesion (HSIL) or malignancy. Although they appear highly anaplastic, cytological features such as high nuclear to cytoplasmic ratio, irregular nuclear contours and scanty basophilic cytoplasm admixed with cytologically benign squamoid and endocervical cells can aid in differentiating them from malignant cells. We present a case of a 37-year-old woman with abnormal uterine bleeding for 3-months. Read More

Placenta 2021 Mar 12. Epub 2021 Mar 12.

Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Westernat Ontario, London, Ontario, N6A5C1, Canada. Electronic address:

Placenta in certain species including the human has evolved as a highly invasive tumor-like organ invading the uterus aned its vasculature to derive oxygen and nutrients for the fetus and exchange waste products. While several excellent reviews have been written comparing hemochorial placentation with tumors, no comprehensive review is available dealing with mechanistic insights into what makes them different, and what tumor biologists can learn from placental biologists, and vice versa. In this review, we analyze the structure-function relationship of the human placenta, emphasizing the functional need of the spatio-temporally orchestrated trophoblast invasiveness for fetal development and growth, and pathological consequences of aberrant invasiveness for fetal and maternal health. Read More

Int J Mol Sci 2021 Apr 7;22(8). Epub 2021 Apr 7.

Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta.

Gynecological cancers pose an important public health issue, with a high incidence among women of all ages. Gynecological cancers such as malignant germ-cell tumors, sex-cord-stromal tumors, uterine sarcomas and carcinosarcomas, gestational trophoblastic neoplasia, vulvar carcinoma and melanoma of the female genital tract, are defined as rare with an annual incidence of <6 per 100,000 women. Rare gynecological cancers (RGCs) are associated with poor prognosis, and given the low incidence of each entity, there is the risk of delayed diagnosis due to clinical inexperience and limited therapeutic options. Read More

Gynecol Oncol Rep 2021 May 13;36:100746. Epub 2021 Mar 13.

Université Tunis EL Manar, Faculté de Médecine de Tunis, Department of Medical Oncology, Abderrahmane Mami Hospital, Tunisia.

Choriocarcinoma is a rare malignancy originating from trophoblastic cells that is known to arise from the placenta. In this report, we describe the case of a 28-year-old female who consulted for amenorrhea and elevated βhCG mimicking a pregnancy of an unknown location, which ultimately turned out to be primary choriocarcinoma of the lung. Read More

Minerva Obstet Gynecol 2021 Apr 20. Epub 2021 Apr 20.

Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.

Fetal growth restriction (FGR) is defined as the inability of the fetus to reach its potential for genetic determination. FGR can have several causes, including genetic syndromes, chromosomal diseases, and infections; however, a vast majority of cases are probably attributed to impaired uterine and placental circulation. The relationships between abnormal placental development and FGR are complex, and studies are generally few, presenting confounding factors. Read More

BMJ Case Rep 2021 Apr 19;14(4). Epub 2021 Apr 19.

Department of Rheumatology, Detroit Medical Center, Detroit, Michigan, USA.

Gestational choriocarcinoma is a rare neoplasm of pregnancy that is often undiagnosed until the advanced stage manifests with metastatic complications. Herein, we present a case of a 22-year-old young woman with metastatic gestational choriocarcinoma with unidentified primary origin, who presented with haemoptysis as a chief problem in her third trimester. The case emphasises on the rarity of this neoplasm in a viable pregnancy. Read More

Gynecol Oncol Rep 2021 May 31;36:100762. Epub 2021 Mar 31.

Wayne State University School of Medicine, Department of Obstetrics and Gynecology, 3980 John R, 7-Brush N, MB #165, Detroit, MI 48201, USA.

•Choriocarcinomas can follow molar, ectopic, or normal pregnancies.•The early diagnosis and treatment of choriocarcinomas is imperative.•Atypical symptoms in pregnancy should raise suspicion for choriocarcinoma. Read More

Mol Genet Metab Rep 2021 Jun 25;27:100747. Epub 2021 Mar 25.

Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, MO, United States of America.

Mucolipidosis type II (MLII, MIM 252500) is a lysosomal storage disorders caused by defects in gene which encodes alpha and beta subunits of -acetylglucosamine (GlcNAc)-1-phosphotransferase. Neonatal presentation includes coarse facial features, restricted postnatal growth, generalized hypotonia, gingival hypertrophy and multiple skeletal anomalies. Here we present a case of a 26-week gestational age preterm infant with MLII who did not exhibit the typical facial features at birth; however, the diagnosis was suggested from abnormal placental pathology showing trophoblastic lipidosis and initial skeletal abnormalities from chest radiograph revealing generalized diffuse severe bone demineralizing disease and multiple fractures. Read More

ESMO Open 2021 Apr 9;6(3):100110. Epub 2021 Apr 9.

Department of Medical Oncology, Gestational Trophoblastic Disease Centre, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK. Electronic address:

Background: A human chorionic gonadotropin (hCG) cut-off of ≤300 IU/l for starting actinomycin D (ActD) in post-molar gestational trophoblastic neoplasia (GTN) patients developing methotrexate resistance (MTX-R) reduced the number of women needing toxic multi-agent chemotherapy (etoposide, MTX and ActD alternating weekly with cyclophosphamide and vincristine; EMA/CO) without affecting survival. Here we assess whether an increased hCG cut-off of ≤1000 IU/l spares more women EMA/CO.

Patients And Methods: All post-molar GTN patients treated with first-line methotrexate and folinic acid (MTX/FA) were identified in a national cohort between 2009 and 2016. Read More

Urol Case Rep 2021 Jul 17;37:101614. Epub 2021 Mar 17.

Nepean Urology Research Group, Nepean Hospital, Kingswood, NSW, Australia.

Gestational choriocarcinoma is an uncommon trophoblastic malignancy, occurring in females after pregnancy, which is rarely encountered by urologists. It can be rapidly progressive, however metastases to other organs can occur after a prolonged latency period. We describe a rare case of solitary metastatic gestational choriocarcinoma presenting with spontaneous bleeding from a renal mass, over a decade after the associated pregnancy with a presumed sub-clinical primary tumour. Read More

J Adolesc Young Adult Oncol 2021 Apr 9. Epub 2021 Apr 9.

Department of Gynecologic Oncology, Adana City Training and Research Hospital, Adana, Turkey.

Choriocarcinoma is an aggressive malignant trophoblastic neoplasm. The rapid growth of neoplastic tissue and myometrial invasion can cause uterine perforation. It is important to quickly diagnose the disease and plan treatment because these tumors are nearly always curable, and fertility can be preserved in most cases with proper management. Read More

Int J Prev Med 2020 11;11:187. Epub 2020 Dec 11.

Non-Communicable Diseases Research Center, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Background: The majority of studies which investigate the predicted power of Human chorionic gonadotropin (hCG) levels to the occurrence of Gestational trophoblastic neoplasia (GTN) considered the effect of a single measurement of hCG or used classical statistical methods without considering the endogenous marker. The aim of this study is to investigate the association between weekly measurements of β-hCG with time to GTN occurring, using a robust Bayesian joint modeling.

Methods: Data of 201 women with a molar pregnancy were considered for this retrospective cohort study. Read More

Int J Gynecol Pathol 2021 Apr 1. Epub 2021 Apr 1.

Departments of Pathology (A. Hamard, A. Heitzmann) Gynecology and Obstetrics (C.C., C.D.), Orleans Regional Hospital, Orléans Department of Pathology (C.M., L.G.-D., F.A.) French Reference Center for Gestational Trophoblastic Diseases, Hospices Civils de Lyon, Lyon Sud University Hospital, Pierre-Bénite (L.G.-D., T.H., J.M., F.A.) Department of Gynecology and Obstetrics, Hospices Civils de Lyon, Femme Mère Enfant University Hospital, Bron (J.M.) Perinatality Center, Pithiviers General Hospital, Pithiviers (C.C., R.V.), France.

Placental mesenchymal dysplasia (PMD) and complete hydatidiform mole (CHM) with a coexisting fetus are 2 rare placental abnormalities characterized by lacunar placenta and presence of an embryo on ultrasound examination. We report the case of a 34-yr-old woman referred at 32.6 weeks of gestation because of a multicystic placenta. Read More

Heliyon 2021 Mar 8;7(3):e06359. Epub 2021 Mar 8.

School of Medicine, University of Minho, Surgical Sciences Domain Research, Campus de Gualtar, 4710-057, Braga, Portugal.

Background: Histopathology of first-trimester abortion products may be useful in document an intrauterine pregnancy, identifying an important pathology affecting the mother or the embryo and diagnosing conditions that are likely to recur in future pregnancies or that explain the adverse fetal outcome. Relevant information provided by histology is essential to determine the cause and to guide the patients with early pregnancy failure.

Aims: Histopathological classification proposal in first-trimester miscarriage. Read More

Best Pract Res Clin Obstet Gynaecol 2021 Feb 2. Epub 2021 Feb 2.

Trophoblastic Disease Centre, Weston Park Cancer Centre, Sheffield, S10 2SJ, United Kingdom. Electronic address:

Low-risk gestational trophoblastic neoplasia (GTN), defined as FIGO/WHO score 0-6, is highly curable with an overall survival rate, which is approximately 100%. For most low-risk GTN patients, first-line single-agent chemotherapy with either methotrexate or actinomycin-D is recommended with overall complete human chorionic gonadotrophin (hCG) response rates of 60%-90% in mostly retrospective, non-randomised studies. The few randomised trials that exist are not appropriately powered or designed to define the optimal first-line treatment. Read More

World J Oncol 2021 Feb 10;12(1):39-43. Epub 2021 Feb 10.

Department of Radiology, Ha Noi Medical University Hospital, Ha Noi, Vietnam.

Gestational choriocarcinoma (GC) is an uncommon malignant tumor consisting of trophoblastic cells. The lungs, liver, and central nervous system are the most common metastatic sites for this disease. However, splenic metastasis is unusual and might result in spontaneous rupture. Read More

JAAPA 2021 Apr;34(4):52-53

Sara Lolar is an assistant professor in the PA program at Wayne State University in Detroit, Mich., and practices in the ED at Detroit Medical Center. The author has disclosed no potential conflicts of interest, financial or otherwise.

Gynecol Oncol 2021 05 5;161(2):454-457. Epub 2021 Mar 5.

Department of Obstetrics and Gynecology, Galilee Medical Centre, Nahariya, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. Electronic address:

Objective: To confirm an increase in the number of women with molar pregnancy during the COVID-19 pandemic.

Methods: In this retrospective cohort study, all patients with complete or partial mole diagnosed at our institution between January 1, 2010 and October 31, 2020, were included. To verify whether there was an increase in the incidence of hydatidiform mole (HM) and deliveries in 2020, the incidences for each year from January 2010 to October 2020 were recorded. Read More

N Engl J Med 2021 03;384(10):936-943

From the Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.

A complete hydatidiform mole (CHM) is a conceptus with only sperm-derived chromosomes. Here, we report on a CHM with genomic DNA identical to that of the paternal somatic cells. The CHM developed in a woman who had undergone intrauterine implantation of a blastocyst obtained through in vitro injection of a presumed round spermatid into one of her oocytes. Read More

Best Pract Res Clin Obstet Gynaecol 2021 Feb 2. Epub 2021 Feb 2.

Trophoblastic Tumour Screening and Treatment Centre, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.

The abnormal pregnancies complete and partial hydatidiform mole are genetically unusual, being associated with two copies of the paternal genome. Typical complete hydatidiform moles (CHMs) are diploid and androgenetic, while partial hydatidiform moles (PHMs) are diandric triploids. While diagnosis can usually be made on the basis of morphology, ancillary techniques that exploit their unusual genetic origin can be used to facilitate diagnosis. Read More

Placenta 2021 Feb 25. Epub 2021 Feb 25.

Cell Biology Laboratory, Institute of Health and Biological Sciences, Federal University of Alagoas, Av. Lourival Melo Mota S/n, 57072-970, Maceio, Brazil. Electronic address:

Gestational trophoblastic diseases are a group of pregnancy-related disorders, originated from trophoblast cells. They include benign and aggressive tumors, such as the invasive mole, the choriocarcinoma, the placental site trophoblastic tumor (PSTT), and the epithelioid trophoblastic tumor (ETT). These malignancies are characterized as gestational trophoblastic neoplasm (GTN), rarer, although more dangerous. Read More

Pak J Med Sci 2021 Mar-Apr;37(2):335-338

Dr. Lumaan sheikh, FRCOG, FCPS. Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi, Pakistan.

Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter.

Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi.

Results: A total of 90 patients were analyzed. Read More

Int J Environ Res Public Health 2021 02 17;18(4). Epub 2021 Feb 17.

Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, 60-572 Poznań, Poland.

Infantile choriocarcinoma is an extremely rare disease. We present a case study of a 1-month-old male with choriocarcinoma diagnosed simultaneously with his mother. On admission to hospital, the disease was very advanced and massive progression and multi-organ failure caused the death of the patient despite the implemented treatment. Read More

Int J Gynecol Cancer 2021 Mar;31(3):399-411

Department of Gynecologic Oncology, Netherlands Cancer Institute, Amsterdam, Noord-Holland, The Netherlands.

The aim of this review is to provide an overview of existing literature and current knowledge on fertility rates and reproductive outcomes after gestational trophoblastic disease. A systematic literature search was performed to retrieve all available studies on fertility rates and reproductive outcomes after hydatidiform mole pregnancy, low-risk gestational trophoblastic neoplasia, high- and ultra-high-risk gestational trophoblastic neoplasia, and the rare placental site trophoblastic tumor and epithelioid trophoblastic tumor forms of gestational trophoblastic neoplasia. The effects of single-agent chemotherapy, multi-agent including high-dose chemotherapy, and immunotherapy on fertility, pregnancy wish, and pregnancy outcomes were evaluated and summarized. Read More

Biochem Biophys Rep 2021 Jul 13;26:100951. Epub 2021 Feb 13.

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Hyperglycosylated human chorionic gonadotropin (H-hCG) is secreted from choriocarcinoma and contains a core2 -glycan formed by core2 β1,6-N-acetylglucosaminyl transferase (C2GnT). Choriocarcinoma is considered immunogenic as it is gestational and contains paternal chromosomal components. Here we examined the function of C2GnT in the evasion of choriocarcinoma cells from natural killer (NK) cell-mediating killing. Read More

Eur J Obstet Gynecol Reprod Biol 2021 Apr 10;259:100-104. Epub 2021 Feb 10.

Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Electronic address:

Objective: Recurrent pregnancy loss (RPL) is a common infertility-related complication that affects approximately 1-3 % of women worldwide. Known causes of etiology are found in approximately half the cases but the other half remain unexplained. It is estimated that several thousands of genes contribute to reproductive success in mammals and the genetic causes of RPL cannot be fully addressed through targeted genetic tests. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 Feb;56(2):147-148

Cancer Manag Res 2021 18;13:1699-1708. Epub 2021 Feb 18.

Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.

Purpose: To alleviate the sufferings of the chemotherapy patients, we developed a novel active targeted therapeutic system and showed its potential as a promising drug delivery strategy.

Methods: We utilized the human chorionic gonadotropin (HCG) ligand-receptor mediation to make an actively targeted drug delivery system with optimal HCG polypeptide fragment as target head base, polyethylene glycol-polylactic acid copolymers as nanometer materials to load chemotherapy drug methotrexate (MTX), to highly selectively deliver MTX into choriocarcinoma lesions, and to investigate the efficacy, targeting and tolerability of the complex in vitro experiments.

Results: Our data show that choriocarcinoma cell lines JEG-3 and JAR exhibited high expression levels of HCG receptor, peptide HCGβ81-95 specifically bonded to HCG receptor-positive cells and HCG81-NP efficiently delivered MTX to choriocarcinoma cells. Read More