27 set. trofoblástica gestacional; dois relataram mola hidatiforme completa, dois às evoluções da doença trofoblástica gestacional, cinco artigos. (2)Rio de Janeiro Trophoblastic Disease Center, Associação Brasileira de Doença Trofoblástica Gestacional, Rio de Janeiro, RJ, Brazil. RESUMO Doença trofoblástica gestacional inclui um grupo interrelacionado de doenças originadas do tecido placentário, com tendências distintas de invasão.

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Belfort P, Braga A. Although chest X-ray is recommended as an initial means of screening for metastases, computed tomography CT and magnetic resonance imaging MRI have generally been incorporated into the evaluation of metastatic disease 2,4especially in more complex clinical cases 2.

Am J Obstet Gynecol. In this review, we present clinical and radiological correlations in patients with GTD, describing the diagnostic requirements for the use of the various ancillary methods, together with details regarding their radiological aspects and therapeutic utility in GTD, testacional well as summarily updating the information about this important complication of pregnancy.

After being diagnosed, patients with GTD should be evaluated at a referral center for its treatment, where the uterine contents can be evacuated by doea aspiration 1,2.

Doença trofoblástica gestacional complicada por hemorragia

Doppler flow studies can also be used to evaluate the response to chemotherapy. MRI scan at 27 weeks of pregnancy, showing a fetus without morphological anomalies and two distinct placental areas: Risk of partial and complete hydatidiform molar pregnancy in relation to maternal age.

Diagnosis, classification and treatment of gestational trophoblastic neoplasia. Is normal beta-hCG regression curve helpful in the diagnosis of persistent trophoblastic disease? Traditionally, such patients have undergone hysterectomy and ligation of the uterine arteries, making subsequent reproduction impossible 2, The PI of the uterine artery is an indirect measure of functional vasculature of the tumor, being considered a predictor of resistance to chemotherapy, especially to methotrexate, regardless of the FIGO score Such signs and symptoms include anemia, hyperemesis gravidarum, hyperthyroidism, respiratory failure, and preeclampsia Masselli G, Gualdi G.


The role of surgery in the management of women with gestational trophoblastic disease.

Pelvic ultrasound showing a massive theca lutein cyst in a patient with complete hydatidiform mole. Myometrial invasion can be suspected when the lesion crosses the myoendometrial border and the transitional zone becomes undefined.

The images seen on an MRI scan have varying characteristics Figure 12depending on the duration of the associated bleeding 20, Gestational trophoblastic frofoblastica Hemorrhagic complications; Chemotherapy. Expert Rev Mol Diagn. The diagnosis of molar pregnancy by On T2-weighted images, a hyperintense mass can be seen in the parametrial tissue, whereas vaginal involvement presents as a bulging into the fornix with a hyperintense signal and ill-defined borders Hemorrhagic complications of gestational trophoblastic disease.

Patients with pulmonary metastases of GTN are also submitted to evaluation of the brain tissue. However, the treatment is preceded by anatomical staging Table 1which allows the results to be compared among various referral centers 20as well as allowing the determination of the FIGO risk score for chemoresistance 7as shown in Table 2, which is fundamental to choosing the treatment strategy, except in cases of PSTT or ETT Low risk of relapse after achieving undetectable HCG levels in women with partial molar pregnancy.

It is noteworthy that the lung is the most common site of GTN 40 and that choriocarcinoma is the GTN subtype most often identified Such abnormalities are best viewed in the second trimester. That dodna does not allow the formation of embryonic tissue or its attachments.


Vascular malformations can be detected years after treatment 2. In the hypervascular form, the tumor has an isointense signal on T1-weighted images, a slightly hyperintense signal on T2-weighted images, and avid uptake after the administration of contrast gadolinium.

In the past, it was common for patients with molar pregnancy to present with marked symptoms: In most cases of GTN, cure doeja be achieved 4.

Doenca Trofoblastica Gestacional

In patients classified as high risk and showing metastasis to the lung or vagina, abdominal CT is recommended Characteristically, they are bilateral and multilocular Figure 4 ; they typically do not require treatment 1. However, the imaging findings are nonspecific and can be difficult to distinguish from those of, for example, retained products of conception or an ectopic pregnancy with GTN Because GTN subtypes are indistinguishable from each other in imaging studies, the diagnostic hypothesis follows a specific sequence.

Current management of gestational gesacional neoplasia. The initial assumption is invasive mole. The management of gestational However, if metastasis is detected, the focus shifts to choriocarcinoma. Rev Bras Ginecol Obstet.


Int J Gynecol Pathol. Routine transvaginal ultrasound at 12 weeks of pregnancy, showing a fetus with normal morphology and a placental area suggestive of complete hydatidiform mole. The autopsy revealed metastatic choriocarcinoma of the liver.