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Gestational trophoblastic disease

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https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#1
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...
January 9, 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
#2
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...
January 4, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28050451/choriocarcinoma-in-ongoing-pregnancy-presenting-with-intracranial-metastasis
#3
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
https://www.readbyqxmd.com/read/28034657/failure-of-physiologic-transformation-of-spiral-arteries-endothelial-and-trophoblast-cell-activation-and-acute-atherosis-in-the-basal-plate-of-the-placenta
#4
Carlos A Labarrere, Hector L Dicarlo, Elaine Bammerlin, James W Hardin, Yeon M Kim, Piya Chaemsaithong, David M Haas, Ghassan S Kassab, Roberto Romero
BACKGROUND: Failure of physiologic transformation of spiral arteries has been reported in preeclampsia, fetal growth restriction, fetal death, and spontaneous preterm labor with intact or ruptured membranes. Spiral arteries with failure of physiologic transformation are prone to develop atherosclerotic-like lesions of atherosis. There are striking parallels between preeclampsia and atherosclerotic disease, and between lesions of atherosis and atherosclerosis. Endothelial activation, identified by intercellular adhesion molecule-1 (ICAM-1) expression, is present in atherosclerotic-like lesions of heart transplantation, and is considered a manifestation of rejection...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28001257/pregnancy-outcomes-after-chemotherapy-for-trophoblastic-neoplasia
#5
Mila Trementosa Garcia, Lawrence Hsu Lin, Koji Fushida, Rossana Pulcineli Vieira Francisco, Marcelo Zugaib
Introduction: The successful development of chemotherapy enabled a fertilitysparing treatment for patients with trophoblastic neoplasia. After disease remission, the outcome of a subsequent pregnancy becomes a great concern for these women. Objective: To analyze existing studies in the literature that describe the reproductive outcomes of patients with trophoblastic neoplasia treated with chemotherapy. Method: Systematic review was performed searching for articles on Medline/ Pubmed, Lilacs and Cochrane Library databases, using the terms "gestational trophoblastic disease" and "pregnancy outcome"...
December 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27996093/dlx3-and-gcm-1-functionally-coordinate-the-regulation-of-placental-growth-factor-in-human-trophoblast-derived-cells
#6
Sha Li, Mark S Roberson
Placental growth factor (PGF) is abundantly expressed by trophoblast cells within human placentae and is important for trophoblast development and placental vascularization. Circulating maternal serum levels of PGF are dynamically upregulated across gestation in normal pregnancies, whereas low circulating levels and placental production of PGF have been implicated in the pathogenesis of preeclampsia and other gestational diseases. However, the underlying molecular mechanism of regulating PGF expression in the human placenta remains poorly understood...
December 20, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27979377/review-sexual-dimorphism-in-the-formation-function-and-adaptation-of-the-placenta
#7
REVIEW
J I Kalisch-Smith, D G Simmons, H Dickinson, K M Moritz
Exposure of the embryo or fetus to perturbations in utero can result in intrauterine growth restriction, a primary risk factor for the development of adult disease. However, despite similar exposures, males and females often have altered disease susceptibility or progression from different stages of life. Fetal growth is largely mediated by the placenta, which, like the fetus is genetically XX or XY. The placenta and its associated trophoblast lineages originate from the trophectoderm (TE) of the early embryo...
December 8, 2016: Placenta
https://www.readbyqxmd.com/read/27965933/colorectal-choriocarcinoma-in-a-patient-with-probable-lynch-syndrome
#8
Viktor H Koelzer, Karl Steuer, Ulrike Camenisch Gross, Dieter Zimmermann, Aino Paasinen-Sohns, Kirsten D Mertz, Gieri Cathomas
BACKGROUND: Personalized therapy of colorectal cancer is influenced by morphological, molecular, and host-related factors. Here, we report the comprehensive clinicopathological and molecular analysis of an extra-gestational colorectal choriocarcinoma in a patient with probable Lynch syndrome. CASE PRESENTATION: A 61-year-old female with history of gastric cancer at age 36 presented with a transmurally invasive tumor of the right hemicolon and liver metastasis. A right hemicolectomy was performed...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27933479/-bunch-of-grapes-in-complete-hydatidiform-mole
#9
REVIEW
Eduardo Kaiser Ururahy Nunes Fonseca, Marina Athaniel Silva Rodrigues, Fernando Ide Yamauchi, Ronaldo Hueb Baroni
Complete hydatidiform mole is a common cause of gestational bleeding of the first trimester, commonly assessed by ultrasound. It represents an abnormal proliferation of trophoblastic tissue, with no fetal formation, just hydropic villi. These abnormal villi seen in ultrasound are compared to a "bunch of grapes," a classic description of this disease.
December 8, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27922982/mir-21-is-overexpressed-in-hydatidiform-mole-tissues-and-promotes-proliferation-migration-and-invasion-in-choriocarcinoma-cells
#10
Ya-Xin Wang, Jiu-Ru Zhao, Yue-Ying Xu, Wei-Bin Wu, Hui-Juan Zhang
OBJECTIVE: The aims of this study were to make clear whether miR-21 was dysregulated in hydatidiform mole (HM) tissues and choriocarcinoma (CCA) cells, to elucidate whether aberrant miR-21 expression would affect the function of CCA cells, and to find out whether there was a relationship between miR-21 and AKT, PDCD4, and PTEN in CCA cells. METHODS: Fresh and formalin-fixed, paraffin-embedded trophoblastic tissues (normal first trimester placentas and HMs) were retrieved from the biobank in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University...
December 3, 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27920694/pancreatic-and-hepatic-metastasis-of-an-undiagnosed-choriocarcinoma-an-exceptional-cause-of-haemoperitoneum-in-young-women-report-of-a-rare-case
#11
Nishat Fatema, Neeru Vinod Arora, Fatma Majid Al Abri, Yaseer Muhammad Tareq Khan
Haemoperitoneum in women of reproductive age usually suggests either ruptured ectopic pregnancy or ruptured ovarian cysts. Metastatic choriocarcinoma is considered the least common cause of haemoperitoneum in women of childbearing age. We report a rare case of pancreatic and hepatic metastasis of choriocarcinoma in a young, 30-year-old female who had delivered 10 months prior at term gestation with no previous history of gestational trophoblastic disease or molar pregnancy. She had a short history of fever and pain in the right hypochondrium, with findings of hypovolaemic shock due to intraperitoneal haemorrhage...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27900108/high-dose-chemotherapy-with-autologous-peripheral-blood-stem-cell-transplantation-for-choriocarcinoma-a-case-report-and-literature-review
#12
Eiko Yamamoto, Kaoru Niimi, Kayo Fujikake, Tetsuya Nishida, Makoto Murata, Ayako Mitsuma, Yuichi Ando, Fumitaka Kikkawa
Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899973/expression-patterns-of-maspin-and-mutant-p53-are-associated-with-the-development-of-gestational-trophoblastic-neoplasia
#13
Pengming Sun, Qibin Wu, Guanyu Ruan, Xiu Zheng, Yiyi Song, Jianfan Zhun, Lixiang Wu, Walter H Gotlieb
Gestational trophoblastic disease (GTD) is a group of conditions that originate from the abnormal proliferation of trophoblastic cells. GTDs encompass hydatidiform moles (HMs) and gestational trophoblastic neoplasia (GTN). GTNs are a group of malignant diseases that require chemotherapy, or more aggressive treatment. There is a requirement for more tumor markers to predict the development of GTN from HMs. The current study evaluated the expression of maspin and tumor protein p53 (p53) in GTD, and their role in predicting the development of GTN...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27896261/giant-invasive-mole-presenting-as-a-cause-of-abdominopelvic-mass-in-a-perimenopausal-woman-an-unusual-presentation-of-a-rare-pathology
#14
Alpaslan Akyol, Memet Şimşek, Özlem Üçer
Invasive mole is a benign gestational trophoblastic disease that arises from the myometrial invasion of any gestational event via direct extension through tissue or vascular structures. Invasive mole (and other gestational trophoblastic diseases) may present with life-threatening complications including uterine perforation, excessive bleeding, acute hemoperitoneum, and abdominal pain. We report a case of invasive mole presenting as abdominal distention in a 51-year-old perimenopausal woman (gravida 12, para 12, abortion 0)...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27871471/endocan-expression-is-increased-in-the-placenta-from-obese-women-with-gestational-diabetes-mellitus
#15
Padma Murthi, Ramona Sarkis, Ratana Lim, Caitlyn Nguyen-Ngo, Anita Pratt, Stella Liong, Martha Lappas
INTRODUCTION: Endocan, a member of the proteoglycan family, is involved in a wide range of diseases including obesity and diabetes. The aim of this study was to determine the effect of (i) maternal obesity and gestational diabetes mellitus (GDM) on placental endocan expression; and (ii) endocan knockdown on markers of inflammation. METHODS: Endocan mRNA and protein expression was determined in human placenta from (i) lean and obese and normal glucose tolerant (NGT) pregnant women (n = 10 patients per group); and (ii) women with GDM and BMI-matched NGT women (n = 40 patients per group)...
December 2016: Placenta
https://www.readbyqxmd.com/read/27871274/chemotherapy-curable-malignancies-and-cancer-stem-cells-a-biological-review-and-hypothesis
#16
Philip Savage
BACKGROUND: Cytotoxic chemotherapy brings routine cures to only a small select group of metastatic malignancies comprising gestational trophoblast tumours, germ cell tumours, acute leukemia, Hodgkin's disease, high grade lymphomas and some of the rare childhood malignancies. We have previously postulated that the extreme sensitivity to chemotherapy for these malignancies is linked to the on-going high levels of apoptotic sensitivity that is naturally linked with the unique genetic events of nuclear fusion, meiosis, VDJ recombination, somatic hypermutation, and gastrulation that have occurred within the cells of origin of these malignancies...
November 21, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27849611/notch1-controls-development-of-the-extravillous-trophoblast-lineage-in-the-human-placenta
#17
Sandra Haider, Gudrun Meinhardt, Leila Saleh, Christian Fiala, Jürgen Pollheimer, Martin Knöfler
Development of the human placenta and its different epithelial trophoblasts is crucial for a successful pregnancy. Besides fusing into a multinuclear syncytium, the exchange surface between mother and fetus, progenitors develop into extravillous trophoblasts invading the maternal uterus and its spiral arteries. Migration into these vessels promotes remodelling and, as a consequence, adaption of blood flow to the fetal-placental unit. Defects in remodelling and trophoblast differentiation are associated with severe gestational diseases, such as preeclampsia...
November 29, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27819410/comparing-and-evaluating-the-efficacy-of-methotrexate-and-actinomycin-d-as-first-line-single-chemotherapy-agents-in-low-risk-gestational-trophoblastic-disease
#18
Young Jae Lee, Jeong Yeol Park, Dae Yeon Kim, Dae Shik Suh, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Joo Hyun Nam
OBJECTIVE: The aim of this study was to compare responses to single-agent chemotherapies and evaluate the predictive factors of resistance in low risk (LR) gestational trophoblastic disease (GTD). The chemotherapy agents included methotrexate (MTX) and actinomycin D (ACT-D). METHODS: We conducted a retrospective study of 126 patients with GTD who were treated between 2000 and 2013. A total of 71 patients with LR GTD were treated with MTX (8-day regimen or weekly regimen, n=53) or ACT-D (bi-weekly pulsed regimen or 5-day regimen, n=18)...
October 7, 2016: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/27807286/fetal-genome-profiling-at-5-weeks-of-gestation-after-noninvasive-isolation-of-trophoblast-cells-from-the-endocervical-canal
#19
Chandni V Jain, Leena Kadam, Marie van Dijk, Hamid-Reza Kohan-Ghadr, Brian A Kilburn, Craig Hartman, Vicki Mazzorana, Allerdien Visser, Michael Hertz, Alan D Bolnick, Rani Fritz, D Randall Armant, Sascha Drewlo
Single-gene mutations account for more than 6000 diseases, 10% of all pediatric hospital admissions, and 20% of infant deaths. Down syndrome and other aneuploidies occur in more than 0.2% of births worldwide and are on the rise because of advanced reproductive age. Birth defects of genetic origin can be diagnosed in utero after invasive extraction of fetal tissues. Noninvasive testing with circulating cell-free fetal DNA is limited by a low fetal DNA fraction. Both modalities are unavailable until the end of the first trimester...
November 2, 2016: Science Translational Medicine
https://www.readbyqxmd.com/read/27793555/a-longitudinal-analysis-of-angiotensin-ii-type-1-receptor-antibody-and-angiogenic-markers-in-pregnancy
#20
Shikha Aggarwal, Neroli Sunderland, Charlene Thornton, Bei Xu, Annemarie Hennessy, Angela Makris
BACKGROUND: Preeclampsia can be caused by shallow trophoblast invasion and results in endothelial dysfunction. Angiotensin II type 1 receptor antibodies (AT1AA) may have a role in both processes. Other angiogenic markers (placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and endoglin (sEng) alter before clinically evident preeclampsia. OBJECTIVES: The aim of this study is to assess the longitudinal changes and utility of biomarkers AT1AA and angiogenic markers in hypertensive disorders of pregnancy; gestational hypertension (GHT) and preeclampsia (PE)...
October 25, 2016: American Journal of Obstetrics and Gynecology
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