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.
|Published (Last):||26 July 2016|
|PDF File Size:||7.63 Mb|
|ePub File Size:||17.64 Mb|
|Price:||Free* [*Free Regsitration Required]|
Doppler flow studies can also be used to evaluate the response to chemotherapy.
Updated diagnostic criteria for partial and complete hydatidiform moles in early pregnancy. Pract Res Clin Obstet Gynaecol. 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 Characteristically, they are bilateral and multilocular Figure 4 ; they typically do not require treatment 1.
In cases of PSTT, lymph node involvement is common 4, Masselli G, Gualdi G. Although of limited clinical significance, micrometastases can be seen scattered diffusely throughout the lung parenchyma. Although biopsy is contraindicated because of the risk of fatal bleeding 43these lesions can respond to selective chemoembolization.
In rare cases, there is adnexal torsion with acute vascular abdomen or rupture that results in hemoperitoneum, both of which call for immediate treatment Contrast-enhanced CT of the chest, acquired during follow-up, showing numerous metastatic lung lesions.
Other conditions can have a similar appearance, such conditions including the presence of residual trophoblastic tissue from a miscarriage or ectopic pregnancy, pelvic inflammatory disease, other uterine malignancies, diverticulitis or appendicitis with uterine abscesses, and uterine arteriovenous malformations Choriocarcinoma is a rarer type that often generates distant metastases.
On CT, GTN confined to the uterus can be described as a low-attenuation lesion within an enlarged uterus Routine terminations of pregnancy — should we screen for gestational trophoblastic neoplasia?
MOLA HIDATIFORME. – ppt video online carregar
At some facilities, despite the superiority of transvaginal imaging, pre-chemotherapy molar pregnancy patients often do not undergo transvaginal ultrasound due to the chance that a vaginal metastasis, which has a risk of major bleeding 2will be encountered.
The most common type of GTN is invasive mole, because, in most cases, the diagnosis is made when the cancer is still confined to the uterus FIGO staging for gestational trophoblastic neoplasia The accuracy of first trimester ultrasound in the diagnosis of hydatidiform mole.
Residual lung lesions after completion of chemotherapy for gestational trophoblastic neoplasia: The diagnosis should always be confirmed by histopathological examination of tissue obtained through uterine evacuation 2.
Posteroanterior chest X-ray, acquired during follow-up, showing numerous, dense, bilateral metastatic nodules, of varying sizes. Other sites are reported to be affected, including the spleen, kidneys, gastrointestinal tract, and skin.
Persistent trophoblast disease following partial molar pregnancy. The images seen on an MRI scan have varying characteristics Figure 12depending on the duration of the associated bleeding 20, Because PSTT and ETT respond poorly to chemotherapy, they gestaciona, be treated with chemotherapy and hysterectomy, sometimes including pelvic lymphadenectomy In order to make that distinction, it should be borne in mind that these neoplasms develop a hypervascular mass with aneurysmal dilatation in the peripheral hepatic arteries, which are best visualized in the arterial phase, whereas persistent vascular lakes are observed in the venous phase.
Am J Obstet Gynecol. After being diagnosed with GTN, patients should first be screened for metastases.
Gestational trophoblastic disease is an abnormality of pregnancy that encompasses a group of diseases that differ from each other in their propensity for trkfoblastica, invasion, metastasis, and recurrence.
Partial hydatidiform mole presents as thickened placental tissue containing various anechoic cystic lesions 31and some cases can present amniotic membranes and a functional umbilical circulation, gestscional depicted in Figure 3 It should be borne in mind that the color Doppler ultrasound features of GTN are nonspecific.
Doenca Trofoblastica Gestacional
Pathology of gestational trophoblastic diseases. Placental site trophoblastic tumor: Hemorrhagic complications of gestational trophoblastic disease. The autopsy revealed metastatic choriocarcinoma of the liver.
Note the presence of hypoechoic areas in the myometrium, resembling the hypervascular “Swiss cheese” aspect, suggestive of an invasive mole, on the Doppler flow study. Prognostic markers and longterm outcome of placental-site trophoblastic tumours: Low-risk persistent gestational trophoblastic disease: Current advances in the management of gestational trophoblastic disease.
Rev Bras Ginecol Obstet. Because it is an unusual and serious disease that affects women of reproductive age, as well as because its appropriate treatment results in high cure rates, it is crucial that radiologists be familiar with gestational trophoblastic disease, in order to facilitate its early diagnosis and to ensure appropriate follow-up imaging.
Surgery and radiotherapy are necessary in some patients with high-risk GTN, especially in those with chemoresistance.
After being diagnosed, patients with GTD should be evaluated at a referral center for its treatment, where trofoblastiica uterine contents can be evacuated by vacuum aspiration 1,2. Combination chemotherapy for highrisk gestational trophoblastic tumour. Pelvic ultrasound showing a massive theca lutein cyst in a patient with complete hydatidiform mole.
However, if metastasis is detected, the focus shifts to choriocarcinoma.