RESUMO
Gestational trophoblastic diseases are a group of pregnancy-related disorders, originated from trophoblast cells. They include benign and aggressive tumors, such as the invasive mole, the choriocarcinoma, the placental site trophoblastic tumor (PSTT), and the epithelioid trophoblastic tumor (ETT). These malignancies are characterized as gestational trophoblastic neoplasm (GTN), rarer, although more dangerous. The diagnosis of GTN is made in most cases by monitoring serum chorionic gonadotropin (hCG) with histological confirmation. The use of specific tissue biomarkers has been increasingly employed as a differential diagnosis, leading to more accurate results and different therapy protocols and prognosis for each GTN. The treatment is based on the International Federation of Gynecology and Obstetrics anatomical staging system and the World Health Organization prognostic score system. If an accurate diagnosis is made and the guidelines followed, the cure for choriocarcinoma and invasive mole cases can reach 98%, whereas PSTT and ETT still present mild success rates. The improved knowledge about GTN and its peculiarities allows physicians to efficiently achieve the differential diagnosis and choose the best available therapy protocol, thus increasing the overall survival of affected women. Nevertheless, obtaining epidemiological data and improving knowledge through basic and translational research are essential to answer open questions on GTN physiopathology, their causes, and cellular behavior.
Assuntos
Doença Trofoblástica Gestacional/diagnóstico , Placenta/patologia , Tumor Trofoblástico de Localização Placentária/diagnóstico , Trofoblastos/patologia , Neoplasias Uterinas/diagnóstico , Biomarcadores Tumorais , Diagnóstico Diferencial , Feminino , Doença Trofoblástica Gestacional/metabolismo , Doença Trofoblástica Gestacional/patologia , Humanos , Placenta/metabolismo , Gravidez , Prognóstico , Tumor Trofoblástico de Localização Placentária/metabolismo , Tumor Trofoblástico de Localização Placentária/patologia , Trofoblastos/metabolismo , Neoplasias Uterinas/metabolismo , Neoplasias Uterinas/patologiaRESUMO
A case study of a 38-year-old woman with a diagnosis of placental site trophoblastic tumor is presented. The patient had a 22-month history of amenorrhea since her last pregnancy, and a dilation and curettage procedure was performed after a 3.1×2.4×2.8 cm endometrial echogenic lesion was visualized on a pelvic ultrasound. When the diagnosis of placental site trophoblastic tumor was made by histopathologic and immunohistochemical analysis, complementary examinations including including pelvic magnetic resonance imaging (MRI) and a chest computed tomography (CT) were done. There was no evidence of disease outside the uterus, and a laparoscopic hysterectomy with bilateral salpingectomy was performed. After a surveillance period of 12 months, no disease recurrence was identified. Best imaging studies, treatment options, and proper surveillance for these type of tumors are discussed alongside the case study.
Assuntos
Tumor Trofoblástico de Localização Placentária/diagnóstico , Neoplasias Uterinas/diagnóstico , Adulto , Feminino , Humanos , Gravidez , Tumor Trofoblástico de Localização Placentária/diagnóstico por imagem , Tumor Trofoblástico de Localização Placentária/metabolismo , Tumor Trofoblástico de Localização Placentária/patologia , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/metabolismo , Neoplasias Uterinas/patologiaRESUMO
La ETG es el término general utilizado para identificar distintos procesos donde existe una hiperplasia de diferentes tipos de epitelio trofoblástico, según la OMS puede clasificarse en 4 tipos: 1) Mola hidatiforme: completa o parcial, más común la primera en un 67 por ciento, 2) Mola invasora (corioadenoma destruens) 3) Coricarcinoma 4)Tumor trofoblástico del lecho placentario, su incidencia varia, pero en países desarrollados se estima sea 1.1/1000 embarazos, siendo esta mas alta en países subdesarrollados se presenta caso clìnico de una paciente la cual se le hace diagnóstico clínico e histopatológico y procedimientos para evacuación uterina por embarazo molar.
Assuntos
Humanos , Adulto , Feminino , Gravidez , Doença Trofoblástica Gestacional/diagnóstico , Doença Trofoblástica Gestacional/patologia , Tumor Trofoblástico de Localização Placentária/patologia , Útero/anatomia & histologia , Coriocarcinoma/patologia , Mola Hidatiforme Invasiva/diagnóstico , Mola Hidatiforme Invasiva/patologiaRESUMO
A clinical case of placental site trophoblastic tumor, is presented in a patient of 27 years old. Diagnosis, clinical behavior and treatment are emphasized in this very infrequent pathology.
Assuntos
Tumor Trofoblástico de Localização Placentária/patologia , Neoplasias Uterinas/patologia , Adulto , Feminino , Seguimentos , Humanos , GravidezRESUMO
Se presenta el caso de una paciente de 27 años con diagnóstico de tumor trofoblástico del sitio placentario. Se incluye una revisión de esta poco frecuente enfermedad trofoblástica, junto al estudio histopatológico e inmunohistoquímico. Se destacan algunos hechos inusuales en la forma de presentación de este caso y se discute el tratamiento y seguimiento ofrecido a nustra paciente