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  • Gestational Trophoblastic Tumors

    A gestational trophoblastic tumor is a form of cancer that grows within the tissues of a woman’s uterus after a pregnancy. Although it is a rare form of cancer, gestational trophoblastic tumors can be treated once diagnosed.

    Many cancerous tumors have been known to develop from cells within the lining of the uterus, but gestational trophoblastic tumor does not. Instead, it forms from placenta cells. It occurs when the sperm and egg conjoin abnormally within the uterus, resulting in an abnormal pregnancy.

    The tumor is formed from cells that would usually develop into the placenta. It is unlike cervical cancer which develops from cells within the uterus. Being a vital organ in a women’s body, the placenta lines the uterus wall and partially encases the fetus, but the uterus is essentially where the baby grows.

    The tumor, which similarly appears to look like small cysts, can be caused due to abnormalities in either one of the parent’s genes. Although it can be treated, the tumor is often benign and hard to locate.

    The three main types of gestational trophoblastic tumors are:

    HYDATIDIFORM MOLE (MOLAR PREGNANCY)

    Being an abnormal form of pregnancy, the mole’s growth consists of an embryo that is incapable of living or growing and breeds within the uterus. Most of the time, it is removed upon diagnosis because it has the capability of developing into choriocarcinoma.

    Hydatidiform mole does not spread outside the uterus to other organs of the body. It similarly appears to look like very tiny cysts that can be seen without the use of a microscope. If left untreated, an abortion may be necessary. Hydatidiform moles are a common defect in pregnancies, and it is often possible for the mother to give birth to a healthy child and be cured of the mole.

    Hydatidiform moles can be split into two categories:

    • Complete Moles: A membrane named chorion, which exists during pregnancy between the fetus and the mother, contains villi (a substance that separates fetal blood from maternal blood). A complete mole consists of chorionic villi that are vesicular (an abnormal growth of the villi), and no signs of fetal development are present.
    • Partial Moles: Some, but not all of the chorionic villi are vesicular, and although some villi appear normal, fetal development may be present, but the embryo lacks the capability of growing or living.

    CHORIOCARCINOMA

    If hydatidiform mole is not treated, an aggressive form of cancer named choriocarcinoma may develop. Unlike hydatidiform mole, choriocarcinoma can spread outside the uterus to other organs of the body. Rarely, choriocarcinomas develop in other parts of the body in both men and women. It may develop in the ovaries, testicles, chest, or abdomen. If not treated, Placental site trophoblastic tumor can develop.

    PLACENTAL SITE TROPHOBLASTIC TUMOR

    This form of gestational trophoblastic disease causes the placenta to attach itself to the uterus. It can develop either after a normal pregnancy or an abortion, but can also occur after a partial mole is removed from the uterus.

    Placental site trophoblastic tumors are not sensitive to chemotherapy, and if diagnosed, they are surgically removed. Thankfully, this tumor cannot spread to other parts of the body, though muscle damage may occur.

    Risk Factors

    Possible risk factors may include:

    • Defects in the egg.
    • Being a female between the ages of 20 and 40.
    • Having a diet low in protein, folic acid (a water-soluble vitamin) and carotene (converts to Vitamin A).
    • Being a blood type A female and a universal donor (type O) male.
    • Prognosis/Statistics

    Gestational trophoblastic tumor occurs once every 1000 pregnancies in the US. After diagnosis, it is recommended to wait 6 to12 months before conceiving again.

    Signs and Symptoms

    The signs and symptoms of gestational trophoblastic tumor may include:

    • Vaginal Bleeding: This is different from menstrual bleeding.
    • Fetal Abnormalities: If the woman is pregnant, but the baby has not moved as expected, a gestational trophoblastic tumor may be present.
    • Size of the Uterus: If the size of the uterus is larger than usual, a gestational trophoblastic tumor may be present.
    • High Blood Pressure: High-blood pressure early in a pregnancy is an indicator of a gestational trophoblastic tumor.

    Diagnosis

    If any of the signs and symptoms listed are present, there are several tests that can be run to find out if a diagnosis is necessary.

    • Ultrasound: A test that uses sound waves to find tumors.
    • Internal (Pelvic) Examination: These are given to women at ages as early as 18, even though young women are becoming sexually active at a much earlier age. The exam is not painful, but doctors look for abnormal discharge, and lesions growth (an infected or diseased patch of skin).
    • Blood Test: A blood test will be given in order to find high levels of beta- HCG (pregnancy “hormone”) that aren’t usually present during pregnancies. If a woman is not pregnant, but traces of beta- HCG are found, this could be a sign of gestational trophoblastic tumor development.

    Treatment

    Treatment options may include:

    • Chemotherapy: Use of chemicals that target cancerous tissues in order to destroy them.
    • Hysterectomy: Surgery to remove the uterus.
    • Radiation Therapy: Treatment of a disease (often times cancerous) by use of radiation.

    Recovery usually goes well, but it ultimately depends on the woman’s health and whether or not the tumor has spread outside of the uterus. The likelihood of it showing up again is not very high.

    Prevention

    To help prevent gestational trophoblastic tumor, it is recommended to maintain a complete and balanced diet, and avoid smoking. Consulting a doctor and regular check-ups will help prevent any type of disease in general. Being aware and informed of the risk factors can also help prevent the disease.