Gestational Trophoblastic Disease

Abstract

The diagnosis of gestational trophoblastic disease has witnessed revolutionary changes with improved availability of immunohistochemistry and genotyping as valuable adjuncts. The term ‘gestational trophoblastic disease’ can be viewed as comprising three groups of conditions. The first group is made up of gestations with morphologic abnormalities in the chorionic villi and variable extent of trophoblastic proliferations, mostly related to the underlying genomic constitutions. The second group is trophoblastic tumors, which include choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. The third group is non-neoplastic trophoblastic lesions, mainly comprising exaggerated placental site and placental site nodule, together with some rare lesions that are being characterised. Hydatidiform moles are genetically abnormal conceptions with excessive paternal contribution to the fetal genomes. The histologic features of complete hydatidiform mole vary with the gestational age. Gestational choriocarcinoma grossly manifests as a bulky mass in the uterine corpus with hemorrhage and necrosis on its cut surface.