Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast T-cells grow inside the uterus after conception. In GTD, a tumor develops inside the uterus from tissue that forms after conception (the joining of sperm and egg). This tissue is made of trophoblast T-cells and normally surrounds the fertilized egg in the uterus. Trophoblast T-cells help connect the fertilized egg to the wall of the uterus and form part of the placenta (the organ that passes nutrients from the mother to the fetus).
Sometimes there is a problem with the fertilized egg and trophoblast T-cells. Instead of a healthy fetus developing, a tumor forms. Until there are signs or symptoms of the tumor, the pregnancy will seem like a normal pregnancy. Most GTD is benign (not cancer) and does not spread, but some types become malignant (cancer) and spread to nearby tissues or distant parts of the body.
Signs & Symptoms
These and other signs and symptoms may be caused by gestational trophoblastic disease or by other conditions. Check with your doctor if you have any of the following:
- Vaginal bleeding not related to menstruation
- A uterus that is larger than expected during pregnancy
- Pain or pressure in the pelvis
- Severe nausea and vomiting during pregnancy
- High blood pressure with headache and swelling of feet and hands early in the pregnancy
- Vaginal bleeding that continues for longer than normal after delivery
- Fatigue, shortness of breath, dizziness, and a fast or irregular heartbeat caused by anemia.
GTD sometimes causes an overactive thyroid. Signs and symptoms of an overactive thyroid include the following:
- Fast or irregular heartbeat
- Shakiness
- Sweating
- Frequent bowel movements
- Trouble sleeping
- Feeling anxious or irritable
- Weight loss
Treatment
There are three types of standard treatment. Your OHC doctor will help you determine the best care plan for you.
- Surgery: The doctor may remove the cancer using one of the following operations:
- Dilatation and curettage (D&C) with suction evacuation: A surgical procedure to remove abnormal tissue and parts of the inner lining of the uterus. The cervix is dilated and the material inside the uterus is removed with a small vacuum-like device. The walls of the uterus are then gently scraped with a curette (spoon-shaped instrument) to remove any material that may remain in the uterus. This procedure may be used for molar pregnancies.
- Hysterectomy: Surgery to remove the uterus, and sometimes the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
- Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
- Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
