Gestational Trophoblastic Disease (GTD) represents a spectrum of rare clinical and pathologic syndromes related to pregnancy and abnormal placental development. As such, these usually develop in young women. GTD includes both benign and malignant forms of diseases of trophoblast. Gestational trophoblastic neoplasia (GTN) refers to those entities that behave in a malignant manner. GTN may occur after an otherwise normal pregnancy or more typically after the occurrence of a non-resolving molar gestation.
Molar pregnancy is typically detected in early pregnancy as the result of ultrasound and blood test (b-HCG) measurements performed during early pregnancy care.
Because of the rare nature of this diagnosis, few physicians have experience in treating this condition. At UHN, we have a dedicated GTD clinic to diagnose and manage women with this diagnosis.
The surgeon may remove GTD with a minor procedure called a dilatation and curettage (D&C). An expert pathologist will evaluate the tissue removed during surgery to determine the diagnosis. Additional treatment depends on the specific subtype, stage of disease and World Health Organization (WHO) score. Treatment may consist of the D&C alone, or with additional chemotherapy. Post treatment monitoring with regular b-HCG blood tests is necessary to ensure cure. Most women who have had GTD can achieve normal pregnancy after completing treatment.