GESTATIONAL TROPHOBLAST NEOPLASIA-GYNAECOLOGICAL & NON GYNAECOLOGICAL MODES OF PRESENTATION: REQUIRING RECOGNITION BY CLINICIANS OF MULTIPLE DISCIPLINES

ABSTRACT
Objective: To analyze the modes of presentation of Gestational Trophoblast Neoplasia(GTN) in our set up and raise
awareness among clinician of all disciplines about wide range of symptoms and clinical findings of these rare but highly
curable gynaecological malignancies.
Study design: Rertospective cohort study
Place& duration of study: From June 2005-June 2014 at Department of obstetrics & gynaecology, Hayatabad Medical
Complex, Peshawar, Pakistan.
Materials & methods: 90 patients with diagnosis of GTN were included in the study. After staging work up patients
were assigned figo risk score and given chemotherapy accordingly. Patients demographic profile, age, parity, antecedent
pregnancy, serum β-hCG levels, site of metastasis, type of chemotherapy, were recorded on performa and
computerized record was kept.
Results: In 90 patients diagnosed with GTN. 73(81.1%) patients were aged less than 40 years with 20(22.2%) patients
being nullipara. Antecedant pregnancy was mole in 50(55.6%) patients. Serum β-hCG level was between 10,000-
100,000 IU/ml in 34(37.8%) & >100,000IU/ml in 27(30%) patients . 43(47.8%) patients presented with complaints of P/V
bleeding.13(14.4%) cases presented with pain abdomen while post evacuation rise of β-hCG was seen in 12 (13.3%)
patients. Hemoptysis was seen in 4(4.4%), cough& breathlessness in 4(4.4%) and paresis/convulsion in 2(2.2%) cases.
Conclusions: Gestational trophoblast neoplasia are rare but highly curable malignancies. High index of suspicion
required in case of unexplained systemic pulmonary, neurological ,genitourinary symptoms in women of reproductive
age group.
Key words: Gestational Trophoblast Neoplasia(GTN), Choriocarcinoma, FIGO Risk Score.