Types of GTD

Molar pregnancies include both complete and partial hydatidiform moles, some are invasive. Some of these are persistent GTD, all of which hold chance to turn malignant.

1. Partial moles are when a regular egg is fertilized by two sperm, doubling the father’s chromosomes, causing fetal abnormalities. Termination is needed.
2. Complete moles are a regular fertilized egg but the egg is missing dna/chromosomes so a fetus cannot be supported, stopping at the formation of the placenta. Complete moles hold higher percentage to turn into malignant choriocarcinoma.
3. Twin molar pregnancies are more rare and can be either partial twin or complete twin. Some cases have viable twin some have surviving twin. Of these cases, not all are caught during prenatal care, thus complicating the situation for both mother and fetus’.

Choriocarcinoma is a highly aggressive and fast growing malignant form of GTD usually from molar pregnancies, particularly complete, but can result form any pregnancy, miscarriage, termination, ectopic or left over fragments.

Chemotherapy is needed, single or multiple regimen, depending on metastasis, FIGO Score and Stage Level. Choriocarcinoma usually results from complete molar pregnancies but partial molars and left over placental fragments can also result into this malignant form of GTD, though more rare.

An even more rare form is Non-Gestational Choriocarcinoma which doesn’t result from any gestational period and is usually on the ovary or teste (testicular choriocarcinoma). Pure form of ovarian choriocarcinoma is very rare. Male choriocarcinoma does not respond well to chemotherapy.

PSTT is another rare form of GTD. This malignant type does not respond well to chemo unlike other GTD forms and a hysterectomy is usually needed. B-hcg levels are also low, opposite of other GTD forms. When chemotherapy fails, new treatments of stem cell transplant and immunotherapy are being used for cure in different countries, though extending more throughout. Cases of PSTT can come years after a pregnancy/childbirth and occurs after pregnancy and are slow growing.