Early Diagnosis of the Trophoblastic Disease
The study comprised 40 cases (15.7%) of chorionepithelioma and 214 cases (84.3%) of hydatidiform mole. According to our study (1992-2001), the incidence of trophoblastic disease, including chorionepithelioma, does not appear to reduce.
Clinical characteristics of the trophoblastic disease strongly depend on the type of clinical variant. Chorionepitheliomas were associated with uterine bleeding and rapid spread to lungs, while hydatidiform moles were associated with expulsion of vesicles along with blood from the uterus and disagreement between the uterine size and gestational dates. Women older than 40 years (OR=2.31), and with history of 5 and more pregnancies and deliveries (OR=1.21 and OR=2.38), induced abortions (OR=1.41), and miscarriages (OR=1.03) have a greater chance of presenting with chrioepitheliomas than with hydatidiform moles.
Because uterine bleeding is the main symptom of trophoblastic disease, which therefore can be confused with miscarriage, dysfunctional uterine bleeding, retained placenta and endometritis, evacuation of the uterus and sending the evacuate to pathology for confirmation is an important practice (Р<0.01).
During trophoblastic disease, blood B-hCG levels dramatically increase. Levels of -hCG are higher and take more time decreasing to normal levels in chorionepitheliomas compared with hydatidiform moles, indicating that measuring B-hCG provides many advantage in monitoring the disease and treatment outcomes.