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Gestational trophoblastic disease

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https://www.readbyqxmd.com/read/28329740/human-chorionic-gonadotropin-regression-curves-after-partial-or-complete-molar-pregnancy-in-flanders-are-they-different-from-regression-curves-from-the-eighties
#1
Sien Delattre, Sileny Han, Philippe Moerman, Jaak Billen, Frédéric Goffin, Kathleen Scharpé, Ignace Vergote
BACKGROUND/AIMS: We updated human chorionic gonadotropin (hCG) regression curves created in the eighties after evacuation of complete and partial molar (CM and PM, respectively) pregnancies using modern hCG assays. We created similar curves for patients in need of chemotherapy (gestational trophoblastic neoplasia [GTN]). METHODS: A total of 126 patients who were diagnosed with gestational trophoblastic disease from 1990 to 2014 were included. We compared curves from 2 groups, CM and PM, with historical ones...
March 23, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28318556/natural-killer-cells-in-placentation-and-cancer-implications-for-hypertension-during-pregnancy
#2
Heather Yvonne Small, Denise C Cornelius, Tomasz J Guzik, Christian Delles
Hypertension during pregnancy is the most common medical condition encountered during gestation. Despite this, knowledge of the mechanisms that underlie the disease and the development of new therapies are limited. Hypertension during pregnancy and some forms of cancer confer an increased risk to the development of cardiovascular disease later in life; one mechanism which may link these conditions is the involvement of natural killer (NK) cells. Whilst immunology and immunotherapy are well-developed areas in oncology; the complex mechanisms of the immune system in health and disease at the maternal-fetal interface are less well-defined...
March 7, 2017: Placenta
https://www.readbyqxmd.com/read/28287945/gestational-trophoblastic-disease-clinical-and-imaging-features
#3
Akram M Shaaban, Maryam Rezvani, Reham R Haroun, Anne M Kennedy, Khaled M Elsayes, Jeffrey D Olpin, Mohamed E Salama, Bryan R Foster, Christine O Menias
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. The latter four entities are referred to as gestational trophoblastic neoplasia (GTN). These conditions are aggressive with a propensity to widely metastasize. GTN can result in significant morbidity and mortality if left untreated. Early diagnosis of GTD is essential for prompt and successful management while preserving fertility...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28272653/we-can-diagnose-it-if-we-consider-it-diagnostic-pitfall-for-placenta-placental-mesenchymal-dysplasia
#4
Havva Serap Toru, Esra Çobankent Aytekin, Cem Yaşar Sanhal, Sezin Yakut, Zafer Çetin, İbrahim İnanç Mendilcioğlu, Hadice Elif Peştereli
Placental mesenchymal dysplasia is an increasingly recognizable abnormality. Early cases have been confused with partial hydatidiform mole. Placental mesenchymal dysplasia is probably under-diagnosed because of being an unfamiliar clinical entity and also mistaken for gestational trophoblastic disease due to the similar sonographic findings of two entities. In this report, we describe the clinical, gross, and histopathological findings of placental mesenchymal dysplasia in two cases. The 33-week-preterm baby of a 26-year-old woman with cardiovascular disease and 342 gram placenta and the 19-week fetus with trisomy 21 of a 40 year-old woman were terminated...
February 4, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28262230/placental-hemostasis-and-sterile-inflammation-new-insights-into-gestational-vascular-disease
#5
Shrey Kohli, Berend Isermann
Activation of the coagulation and inflammatory systems are physiologically occurring during pregnancy. However, excess activation of either system is well documented in gestational vascular diseases (GVD). GVD are placenta-mediated pregnancy complications and a major cause of feto-maternal morbidity and mortality. The causal relevance of excess coagulation and inflammatory responses for GVD remains largely unknown. Deciphering the causal relationship of excess coagulation and inflammation in GVD may allow conceptualizing new therapeutic approaches to combat GVD...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28259870/c-rel-promotes-invasion-of-choriocarcinoma-cells-via-pi3k-akt-signaling
#6
Yoko Sekiya, Eiko Yamamoto, Kaoru Niimi, Kimihiro Nishino, Kenichi Nakamura, Tomomi Kotani, Hiroaki Kajiyama, Kiyosumi Shibata, Fumitaka Kikkawa
OBJECTIVE: Choriocarcinoma is the most common epithelial cancer among gestational trophoblastic diseases (GTDs); the mechanism of trophoblastic carcinogenesis is unknown. This study aimed to examine the expression of NF-κB family proteins in GTDs and placental tissues as well as the roles of c-Rel in choriocarcinoma. METHODS: We examined the expression of NF-κB family proteins in normal placenta and hydatidiform mole tissues as well as extravillous trophoblast (EVT) and choriocarcinoma cell lines by Western blot and immunohistochemistry...
March 4, 2017: Oncology
https://www.readbyqxmd.com/read/28246515/efficacy-of-prophylactic-uterine-artery-embolization-before-obstetrical-procedures-with-high-risk-for-massive-bleeding
#7
Heung Kyu Ko, Ji Hoon Shin, Gi Young Ko, Dong Il Gwon, Jin Hyung Kim, Kichang Han, Shin-Wha Lee
OBJECTIVE: To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding. MATERIALS AND METHODS: A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1)...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28217684/extrauterine-epithelioid-trophoblastic-tumor-in-hysterectomized-woman
#8
Ji-Hye Kim, Sun Kyung Lee, Soo Hyun Hwang, Jung-Sun Kim, Gun Yoon, Yoo-Young Lee, Tae-Joong Kim, Chel Hun Choi, Byoung-Gie Kim, Duk-Soo Bae, Jeong-Won Lee
Epithelioid trophoblastic tumor (ETT) is a very rare variant of gestational trophoblastic disease (GTD) which arises in reproductive age women with prior gestational history. Although abnormal vaginal bleeding is the most common symptom of ETT, there are no reported pathognomonic symptoms of ETT because of its rarity. ETT is similar to placental site trophoblastic tumor in terms of its slow growing characteristic and microscopic findings. Therefore, it could be misdiagnosed as placental site trophoblastic tumor or other types of GTD...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28193709/testosterone-represses-estrogen-signaling-by-upregulating-mir-22-a-mechanism-for-imbalanced-steroid-hormone-production-in-preeclampsia
#9
Xuan Shao, Yanlei Liu, Ming Liu, Yongqing Wang, Liying Yan, Hao Wang, Liyang Ma, Yu-Xia Li, Yangyu Zhao, Yan-Ling Wang
Preeclampsia, a multisystem syndrome occurring during mid- to late gestation in humans, is a leading cause of maternal and perinatal morbidity and mortality. Patients usually present with high circulating testosterone and reduced estradiol production, but the mechanisms remain unclear. Revealing the mechanism that modulating the imbalance of testosterone and estradiol in preeclampsia is of great value in understanding the cause of the disease. The placenta is the predominant source of steroid hormone production during gestation, and we observed markedly increased 17β-HSD3 (17β-hydroxysteroid dehydrogenase 3) levels and downregulated aromatase expression, the key enzymes responsible for synthesis of testosterone and estradiol, respectively, in preeclamptic placentas compared with controls...
February 13, 2017: Hypertension
https://www.readbyqxmd.com/read/28161066/genomic-profile-in-gestational-and-non-gestational-choriocarcinomas
#10
Julia Bette Homem de Mello, Priscila Daniele Ramos Cirilo, Odair Carlito Michelin, Maria Aparecida Custódio Domingues, Marilza Vieira Cunha Rudge, Silvia Regina Rogatto, Izildinha Maestá
INTRODUCTION: Gestational (GC) (derived from the placenta) and non-gestational (NGC) choriocarcinomas are trophoblastic diseases originated from abnormal proliferation of trophoblastic cells. These rare tumors share similar morphology and pathological features and differ on chemotherapy response, genetic origin and prognosis. In this study, the genomic profile of choriocarcinomas was performed according to their origin (GC or NGC) aiming to better understand these poorly characterized diseases...
February 2017: Placenta
https://www.readbyqxmd.com/read/28141940/are-early-pregnancy-complications-more-common-in-women-with-hyperemesis-gravidarum
#11
Sinead R Morgan, Lisa Long, Jemma Johns, Chloe Angwin, Supriya Maitra, Jackie A Ross
Ultrasound evaluation is usually requested for women presenting with hyperemesis gravidarum (HG) in early pregnancy. This is to check viability as well as to diagnose multiple pregnancies and exclude gestational trophoblastic disease (GTD). The aim of this retrospective case control study was to evaluate the early pregnancy outcomes in women with HG and to compare them with an asymptomatic control group. 790 women referred with HG between 2002 and 2014 were matched for gestational age and maternal age with an asymptomatic patient attending for a reassurance or dating scan...
January 31, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28134999/pathogenesis-of-hyperthyroidism
#12
Ishita Singh, Jerome M Hershman
Hyperthyroidism is a form of thyrotoxicosis in which there is excess thyroid hormone synthesis and secretion. Multiple etiologies can lead to a common clinical state of "thyrotoxicosis," which is a consequence of the high thyroid hormone levels and their action on different tissues of the body. The most common cause of thyrotoxicosis is Graves' disease, an autoimmune disorder in which stimulating thyrotropin receptor antibodies bind to thyroid stimulating hormone (TSH) receptors on thyroid cells and cause overproduction of thyroid hormones...
December 6, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/28132722/multiple-pregnancies-with-complete-mole-and-coexisting-normal-fetus-in-north-and-south-america-a-retrospective-multicenter-cohort-and-literature-review
#13
Lawrence H Lin, Izildinha Maestá, Antonio Braga, Sue Y Sun, Koji Fushida, Rossana P V Francisco, Kevin M Elias, Neil Horowitz, Donald P Goldstein, Ross S Berkowitz
OBJECTIVE: To determine the clinical characteristics of multiple gestation with complete mole and coexisting fetus (CHMCF) in North and South America. METHODS: Retrospective non-concurrent cohorts compromised of CHMCF from New England Trophoblastic Disease Center (NETDC) (1966-2015) and four Brazilian Trophoblastic Disease Centers (BTDC) (1990-2015). RESULTS: From a total of 12,455 cases of gestational trophoblastic disease seen, 72 CHMCF were identified...
January 26, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28129241/role-of-surgery-in-the-management-of-hydatidiform-mole-in-elderly-patients-a-single-center-clinical-experience
#14
Veronica Giorgione, Alice Bergamini, Raffaella Cioffi, Francesca Pella, Emanuela Rabaiotti, Micaela Petrone, Massimo Candiani, Giorgia Mangili
OBJECTIVE: Women older than 40 years develop gestational trophoblastic neoplasia (GTN) after a hydatidiform mole (HM) more often than do younger women. Therefore, in elderly women, primary hysterectomy has been advocated as first-line treatment. The aim of the present study was to evaluate whether hysterectomy could reduce the incidence of GTN after a diagnosis of HM. METHODS: Seventy-six of 442 patients referred to our unit for an HM between 1994 and 2015 were older than 40 years old...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28117145/notch-signalling-in-placental-development-and-gestational-diseases
#15
S Haider, J Pollheimer, M Knöfler
Activation of Notch signalling upon cell-cell contact of neighbouring cells controls a plethora of cellular processes such as stem cell maintenance, cell lineage determination, cell proliferation, and survival. Accumulating evidence suggests that the pathway also critically regulates these events during placental development and differentiation. Herein, we summarize our present knowledge about Notch signalling in murine and human placentation and discuss its potential role in the pathophysiology of gestational disorders...
January 16, 2017: Placenta
https://www.readbyqxmd.com/read/28117143/review-placental-derived-biomarkers-of-pregnancy-disorders
#16
REVIEW
James S M Cuffe, Olivia Holland, Carlos Salomon, Gregory E Rice, Anthony V Perkins
Pregnancy is one of the greatest physiological challenges that a women can experience. The physiological adaptations that accompany pregnancy may increase the risk of developing a number of disorders that can lead to both acute and chronic physiological outcomes. In addition, fetal development may be impaired and, if the fetus survives, the child may be at an increased risk of disease throughout life. Pregnancy disorders are poorly predicted by traditional risk factors and maternal history alone. The identification of biomarkers that can predict incidence and severity of disease would allow for improved and targeted prophylactic therapies to prevent adverse maternal and fetal outcomes...
January 16, 2017: Placenta
https://www.readbyqxmd.com/read/28110749/contribution-of-syncytins-and-other-endogenous-retroviral-envelopes-to-human-placenta-pathologies
#17
P-A Bolze, M Mommert, F Mallet
Fusion, proliferation, angiogenesis, immune tolerance, and tissue survival are some of the critical functions involved in the physiological and pathological processes of placenta development. Strikingly, some of these properties are shared by envelope glycoproteins of retroviruses. Part of the overall retroviral world, the human retroviral heritage consists of hundred thousands of elements representing a huge amount of genetic material as compared to our 25,000 genes, whereas only a few tenths of retroviral loci still contain envelope genes exhibiting large open reading frames...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#18
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28060141/pd-l1-expression-in-premalignant-and-malignant-trophoblasts-from-gestational-trophoblastic-diseases-is-ubiquitous-and-independent-of-clinical-outcomes
#19
Pierre-Adrien Bolze, Sophie Patrier, Jérôme Massardier, Touria Hajri, Fatima Abbas, Anne Marie Schott, Fabienne Allias, Mojgan Devouassoux-Shisheboran, Gilles Freyer, François Golfier, Benoît You
OBJECTIVE: Recently reported expression of programmed cell death 1 ligand 1 (PD-L1) in gestational trophoblastic diseases (GTDs) suggests that the immune tolerance of pregnancy might be hijacked during neoplastic process. We assessed PD-L1 protein expression in premalignant and malignant GTD lesions and analyzed associations with disease severity and chemotherapy outcomes. METHODS: We included 83 GTD whole-tissue sections from 76 patients in different treatment settings...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28050451/choriocarcinoma-in-ongoing-pregnancy-presenting-with-intracranial-metastasis
#20
Sujata Siwatch, Vanita Suri, Pooja Sikka, Neelam Aggarwal, Seema Chopra
Choriocarcinoma presents usually as persistent trophoblastic disease, with prognosis worsening with duration from antecedent pregnancy. We present a unique case of a woman with choriocarcinoma who presented in the third trimester of pregnancy with eclampsia. She was managed with magnesium sulphate and underwent a caesarean section. However, she developed seizures in the post-partum period that were further investigated and attributed to intracranial metastatic lesions of Gestational Trophoblastic Neoplasia (GTN)...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
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