What is Gestational trophoblastic disease

TL;DR: Gestational trophoblastic disease (GTD) is a group of rare, pregnancy-related conditions where abnormal cells grow inside the uterus from tissue that would normally form the placenta. While most cases are curable, they require specialized medical monitoring to ensure that these abnormal cells do not persist or spread beyond the uterus.

What exactly is Gestational trophoblastic disease?

Gestational trophoblastic disease refers to a spectrum of conditions that develop from the trophoblast cells—the cells that normally surround an embryo and form the placenta. In cases of Gestational trophoblastic disease, these cells grow in an uncontrolled manner. Unlike a typical pregnancy, the tissue does not develop into a healthy fetus. Because these cells naturally produce a hormone called human chorionic gonadotropin (hCG), doctors use levels of this hormone in the blood as a primary marker to track the presence and behavior of the disease.

What are the main types of Gestational trophoblastic disease?

The classification of Gestational trophoblastic disease is essential for determining the appropriate treatment plan. These conditions are generally divided into two main categories: benign (non-cancerous) and malignant (cancerous). The most common classifications include:

• Hydatidiform Mole (Molar Pregnancy): The most common form of Gestational trophoblastic disease. It can be a "complete" mole (no fetal tissue present) or a "partial" mole (some abnormal fetal tissue may be present).


• Invasive Mole: A molar pregnancy that invades the muscular wall of the uterus.


• Choriocarcinoma: A rare, fast-growing form of cancer that can develop after any type of pregnancy, including a molar pregnancy, miscarriage, or even a full-term birth.


• Placental-site Trophoblastic Tumor (PSTT): An extremely rare type of Gestational trophoblastic disease that develops where the placenta was attached to the uterine wall.

Who is typically affected by this condition?

Gestational trophoblastic disease can occur in any person who becomes pregnant. However, the risk is statistically higher at the extremes of reproductive age—specifically in individuals under the age of 20 or over the age of 40. While the exact incidence varies globally, in North America and Europe, a molar pregnancy occurs in approximately 1 out of every 1,000 to 1,500 pregnancies. Geography plays a role, with higher rates of Gestational trophoblastic disease reported in parts of Southeast Asia and Japan.

What differentiates Gestational trophoblastic disease from other conditions?

The primary factor that makes Gestational trophoblastic disease unique is its origin in placental tissue and its ability to secrete hCG. Unlike other gynecological cancers, the management of Gestational trophoblastic disease is often highly successful, even when the disease has spread, because these cells are generally very sensitive to chemotherapy. For the 406 community members at DiseaseMaps.org who have navigated this diagnosis, early detection through consistent follow-up of hCG levels remains the gold standard for long-term health.

Next steps

• Consult a specialist: Seek care from a gynecologic oncologist, as they have the most experience managing the complexities of Gestational trophoblastic disease.


• Monitor hCG levels: Follow your medical team's exact schedule for blood tests to ensure hCG levels return to and remain at zero.


• Join our community: Connect with others at DiseaseMaps.org who have lived experience with this condition to share resources and emotional support.


• Do not rush future pregnancies: Discuss with your doctor when it is safe to attempt another pregnancy, as early conception can interfere with monitoring your hCG levels.

Medical disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment; always seek the advice of your physician or qualified health provider with any questions regarding a medical condition.

References

• NIH Genetic and Rare Diseases Information Center (GARD): Gestational Trophoblastic Disease.


• Orphanet: Rare Disease Database (ORPHA:99925).


• American Cancer Society: What is Gestational Trophoblastic Disease?


• National Cancer Institute (NCI): Gestational Trophoblastic Disease Treatment (PDQ).