What is gestational trophoblastic neoplasia?
Gestational trophoblastic neoplasia affects a woman’s uterus. As part of a woman’s reproductive system, the uterus (womb) is where a fetus (unborn baby) grows during pregnancy. In the earliest stages of pregnancy, trophoblast cells normally surround the embryo (unborn baby) and eventually develop into the placenta. The placenta attaches to the wall of the uterus and provides oxygen and nutrients to the growing baby through the umbilical cord.
Normally, cells in the body will grow and divide to replace old or damaged cells. This growth is usually precise. Once enough cells are produced to replace the old ones, normal cells stop dividing. Tumors occur when there is an error and cells continue to grow uncontrollably. With gestational trophoblastic neoplasia, a tumor begins from the trophoblast cells of the uterus.
There are four types of malignant (cancerous) gestational trophoblastic neoplasia.
- Invasive moles are trophoblast cells that grow into the muscle layer of the uterus.
- Choriocarcinomas are trophoblast cells that spread (metastasize) to the muscle layer of the uterus, nearby blood vessels and possibly other organs.
- Placental-site trophoblastic tumors are rare, slow-growing and spread into the muscle of the uterus, blood vessels. They may also spread (metastasize) to the lungs, pelvis, or lymph nodes.
- Epithelioid trophoblastic tumors are very rare tumors and can spread (metastasize) to the lungs.
Compared to other reproductive cancers, gestational trophoblastic neoplasia is usually curable, especially if detected early. Successful treatment of gestational trophoblastic neoplasia depends on age, stage and location of cancer and other factors.
What are the symptoms of gestational trophoblastic neoplasia?
Symptoms vary by type of gestational trophoblastic neoplasia but may include:
- Enlarged uterus
- Excessive vomiting
- Pelvic pain or discomfort
- Abnormal vaginal bleeding post-pregnancy
- Acute respiratory or neurological symptoms post-pregnancy
What causes gestational trophoblastic neoplasia?
There are no clear causes for gestational trophoblastic neoplasia. However, possible risk factors may include:
- Prior miscarriage
- Family history of gestational trophoblastic neoplasia
- Age at the time of pregnancy (being under 20 years of age or over 35 years of age)
- Prior molar pregnancy (a noncancerous tumor that develops from a nonviable pregnancy)
How is gestational trophoblastic neoplasia diagnosed?
First, your doctor will learn your and your family’s medical history and perform a physical exam. Your doctor may perform or order one or more of the following tests:
- Pelvic exam
- Blood tests
- Urinalysis (a urine test)
- Serum tumor marker tests (blood test for tumor markers)
To learn how severe the cancer may be, your doctor will classify it by stage and grade.
How is gestational trophoblastic neoplasia treated?
Gestational trophoblastic neoplasia is most commonly treated with surgery. The following treatments may also be used:
- Radiation Therapy
- Clinical trials (experimental treatments)
Your treatment will depend on age, overall health, cancer stage, cancer size and location, and other factors.