Pregnant-induced rophoblastic disease is a benign development condition after curettage, about 20% complicated development. In international other studies and Vietnam, the patients don't stringently comform to follow-up after curettage, outpatient treatment and reexamining after molar pregnancy. The authors showed that ist is neccessary to treat preventive chemography for all patients with molar pregnancy at higher risk
Hydatidiform Mole ; Curettage ; Pregnant Women ; drug therapy

We treated a 54-year-old woman who was suffering from membranoproliferative glomerulonephritis associated with a complete type of hydatidiform mole. The renal manifestations were proteinuria and hematuria. A renal biopsy, performed before gynecologic management, disclosed focal and segmental subendothelial deposits with a proliferation of the mesangial cell and showed irregularly thickened capillary loops by light and electronmicroscoy. Genralized edema, proteinuria and hematuria were completely recovered by suction and curettage of the hydatidiform mole with prophylactic chemotherapy. The clinical manifestation of earlier presented 3 cases have been the nephrotic syndrome. The common feature of them was a complete remission of the nephropathy after the removal of the hydatidiform mole. The relationship between the hydatidiform mole and glomerulonephritis remains unresolved at present. But we concluded that the hydatidiform mole might be a cause of glomerulonephritis in this case.
Case Report ; Diagnosis, Differential ; Edema/etiology ; Female ; Glomerulonephritis, Membranoproliferative/pathology ; Glomerulonephritis, Membranoproliferative/etiology* ; Hematuria/etiology ; Human ; Hydatidiform Mole/therapy ; Hydatidiform Mole/diagnosis* ; Hydatidiform Mole/complications* ; Middle Age ; Pregnancy ; Proteinuria/etiology ; Uterine Neoplasms/therapy ; Uterine Neoplasms/diagnosis* ; Uterine Neoplasms/complications*

For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

The purpose of this study was to evaluate the significance of telomerase activity in gestational trophoblastic disease and the association of telomerase activity in complete hydatidiform mole and subsequent development of persistent gestational trophoblastic tumor. By using the standard telomerase repeat assay, we examined telomerase activity in 2 normal placentas, 31 complete hydatidiform moles, 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). Telomerase activity was detected in 13 of 15 (86.7%) complete hydatidiform mole patients who eventually had chemotherapy for the treatment of persistent gestational trophoblastic tumor. All of the 9 patients with metastatic disease (FIGO Stage III) had telomerase activity in their initial molar tissue. In contrast, telomerase activity was evident in only two of 16 (12.5%) complete hydatidiform mole patients with spontaneous remission. While telomerase activity was not detected in normal placentas, high level of telomerase activity was detected in all of 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). The presence of telomerase activity in a complete hydatidiform mole is associated with the development of persistent gestational trophoblastic tumor, such as invasive mole and choriocarcinoma.
Cell Line ; Choriocarcinoma ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Molar ; Placenta ; Pregnancy ; Remission, Spontaneous ; Telomerase* ; Telomere ; Trophoblastic Neoplasms

Persistent tumor, usually non-metastatic, develops in approximately 4% of patients with a partial mole, and chemotherapy is required to achieve remission. Following evacuation of hydatidiform mole, careful hCG monitoring is mandatory since it is the most reliable and sensitive method for the early detection of gestational trophoblastic disease. In carefully selected patients in whom the risk of developing gestational trophoblastic disease is significant or when the availability of hCG testing is suboptimal, chemoprophylaxis has been shown to decrease the risk of gestational trophoblastic tumor. We report here a case of patient, 23- year-old woman who experienced unusual course after the evacuation of a partial mole and markedly elevated serum beta-hCG levels. The patient developed persistent metastatic gestational trophoblastic disease and was successfully treated with 3 courses of EMA-CO.
Chemoprevention ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Humans ; Hydatidiform Mole* ; Pregnancy ; Trophoblastic Neoplasms

OBJECTIVE: To evaluate the clinical characteristics and the outcome of the management for gestational trophoblastic disease (GTD) patients diagnosed at our hospital and to report the current situation of GTD in Korea. METHODS: Between January, 1991, and December, 2000, One hundred and eleven women were diagnosed as GTD and managed in our hospital. Patients were classified according to clinical diagnosis and their medical records were investigated. RESULTS: Cases of benign, malignant nonmetastatic, malignant metastatic low risk and malignant metastatic high risk GTDs were 62, 36, 2 and 11 respectively. The mean age (year), gravidity and parity (number) of GTD patients were 33.3+/-9.9 (range: 19-54), 3.2+/-3.0 (range: 0-16) and 1.7+/-1.8 (range: 0-7) overall. About 75% of GTD patients were women in their 20s and 30s, and 85% occurred in patients with parity of 3 or less. The most common prior gestational event was abortion (37.1%) for molar pregnancy and molar pregnancy (61.2%) for persistent gestational trophoblastic tumor (PGTT). The progression rate of molar pregnancies to PGTT was 38.0%. MTX (16.3%) was mainly used as a single agent, and EMACO (28.6%) or MAC (22.4%) were primarily used for multidrug chemotherapy for the treatment of PGTT. In the treatment of PGTT, overall remission rate was 95.9% (n=47/49). CONCLUSION: The trends for GTD in Korea revealed significant changes, not only a decrease in the incidence of GTD, but also an improvement in the outcome of the management. There is a necessity of further community-based surveys for GTD.
Diagnosis ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gravidity ; Humans ; Hydatidiform Mole ; Incidence ; Korea ; Medical Records ; Parity ; Pregnancy ; Trophoblastic Neoplasms

Gestational trophoblastic disease is derived from the intermediate trophoblast cells which are arisied from the fetal chorion. The incidence of invasive mole in Korea was about 1.8 per 1000 delivereies. The rate of ectopic pregnancy is about 1.9% of all pregnancies. An ectopic pregnancy located in the cornual portion of uterus occurs in only 2-4% of all ectopic pregnancies. It is rare that the invasive mole is associated with cornual pregnancy. A case of metastatic invasive mole in the lung arising from a cornual pregnancy is reported, which was cured by operation and combination chemotherapy.
Chorion ; Drug Therapy, Combination ; Female ; Gestational Trophoblastic Disease ; Hydatidiform Mole, Invasive* ; Incidence ; Korea ; Lung* ; Pregnancy ; Pregnancy* ; Pregnancy, Ectopic ; Trophoblasts ; Uterus

Gestational trophoblastic disease comprises a spectrum of interrelated conditions originating from the placenta. Malignant gestational trophoblastic disease refers to lesions that have the potential for local invasion and metastasis. This compromises many histological entities including hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors. Before the advent of sensitive assays for human chorionic gonadotropin (hCG) and efficacious chemotherapy, the morbidity and mortality from gestational trophoblastic disease were substantial. Currently, with sensitive quantitative assays for beta-hCG and current approaches to chemotherapy, most women with malignant trophoblastic disease can be cured. We present a case of malignant gestational trophobalstic tumor with serum beta-hCG concentration over 1million IU/L that metastaze to the lungs and have a hyperthyroidism, but negative urine hCG testing. We report a case with a brief review of literatures.
Choriocarcinoma ; Chorionic Gonadotropin ; Drug Therapy ; Female ; Gestational Trophoblastic Disease ; Humans ; Hydatidiform Mole, Invasive ; Hyperthyroidism ; Lung ; Mortality ; Neoplasm Metastasis ; Placenta ; Pregnancy ; Trophoblastic Tumor, Placental Site ; Trophoblasts

A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.
Adult ; Cardiopulmonary Bypass ; Choriocarcinoma* ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Embolectomy* ; Emergencies* ; Female ; Humans ; Hydatidiform Mole, Invasive ; Pregnancy ; Pulmonary Artery* ; Pulmonary Embolism

BACKGROUND: With the widespread use of high resolution ultrasound in early pergnancy periods, poorly formed diagnostic features of complete hydatidiform mole (CHM) (which mimics normal or nonmolar gestation) often lead to a confusion fo CHM with partial mole, hydropic abortion or nonmolar chromosomal abnormalities. METHODS: We studied the clinicopathologic finnings in 51 early CHM, evacuated before 12 weeks of gestation to characterize the early histologic changes. RESULTS: Conventional diagnostic features were not uniformly identified; extensive cavitation was identified in 51.0%, trophoblastic hyperplasia in 49.1%, and avascular villi in 13.7%. The characteristic histologic features of early CHM were cellular and basophilic stroma (82.4%), bulbous projection with linear intervening clefts (76.5%), and apoptotic stromal cells (84.3%). In 86.3%, vascularized chorionic villi showed either primitive vascular network or clearly visible vascular lumen. Nonmetastatic persistent trophoblastic neoplasia developed in 35.3% and all were cured with single-agent or combination chemotherapy. Choriocarcinoma did not develop in any cases. The extent of trophoblastic proliferation at initial curettage han no prognostic value for clinical progression to persistent hydatidiform mole. CONCLUSIONS: The fact that the histologic features of CHM in early gestation are often not as distinctive as those in later gestation should always be kept in mind in the diagnosis of conceptual products in early gestation.
Basophils ; Choriocarcinoma ; Chorionic Villi ; Chromosome Aberrations ; Curettage ; Diagnosis ; Drug Therapy, Combination ; Female ; Hydatidiform Mole* ; Hyperplasia ; Pregnancy ; Pregnancy* ; Stromal Cells ; Trophoblasts ; Ultrasonography