A road map to gestational trophoblastic disease
Number:27ESURABS0019
Type:Educational Electronic Presentation
Authors: Ana Primitivo, Marta Palmeiro
Keywords:gestational trophoblastic disease; hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.
SECTIONS
Educational objective

Review the pathophysiology of the gestational trophoblastic disease, such as complete and partial mole, and gestational trophoblastic neoplasia with radiologic images in different modalities (ultrasound, MRI and CT).

To serve as a learning tool for radiology trainees using illustrations and computer-made schemes.


Topic Review

Gestational trophoblastic disease (GTD) is a spectrum of both benign and malignant gestational tumors, including hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor.

I. Pathophysiology

Trophoblast is a gestational tissue that covers the blastocyst and provides a route for nourishment between the maternal endometrium and the developing embryo in early pregnancy. 

Trophoblast is comprised of cytotrophoblast, syncytiotrophoblast, and intermediate trophoblast. It covers the surface of chorionic villi and forms the fetal portion of the placenta.

In the villous pathway, the mononuclear cytotrophoblast cells forming the internal layer of villi fuse and form the...

...read more

Pathofisiology
Gestational trophoblastic disease scheme


Conclusions

Radiologist plays a key role in the initial diagnosis of GTD and guiding disease management and early detection of its complications.

Ultrasound is the first-line radiological investigation in confirming the diagnosis of GTD in a case suspected on the basis of clinical findings and ????-hCG levels. Invasive mole, choriocarcinoma, and other gestational trophoblastic neoplasias are indistinguishable at imaging.

MRI is invaluable to assess extrauterine disease spread and complications.