What is gestational trophoblastic disease?
GTD is a term that describes a group of growths that can occur inside the uterus after sperm and egg join (conception or fertilization), but do not become a fetus. Although very rare, these growths can become cancerous and spread to other parts of the body.
Types of gestational trophoblastic disease
There are two main types of GTD: hydatidiform mole (HM), also called molar pregnancy, and gestational trophoblastic neoplasia (GTN).
Hydatidiform mole (HM) or molar pregnancy is the most common form of GTD. It is most often benign (non-cancerous) and stays in the uterus. There are two types of HM: complete HM, which has a 15 to 25 percent chance of becoming cancer, and partial HM, which has a less than 5 percent chance of becoming cancer.
There are four main types of GTN:
- Invasive moles (chorioadenoma destruens): Cancerous growths that can develop from HM but rarely spread outside of the uterus.
- Choriocarcinoma: A tumor that can develop from HM or after an abortion, miscarriage, ectopic pregnancy, or full-term pregnancy. Choriocarcinomas are the most aggressive form of GTN and can spread throughout the pelvis and to distant sites, such as the lungs, brain, liver, and kidneys.
- Placental-site trophoblastic tumor (PSTT): A very rare, slow-growing cancer that develops from the placenta.
- Epithelioid trophoblastic tumor (ETT): A very rare cancer that is similar to choriocarcinoma but less aggressive.
Signs and symptoms of gestational trophoblastic disease
Gestational trophoblastic disease (GTD) and choriocarcinoma, a type of gestational trophoblastic neoplasia (GTN), often show the signs and symptoms of a normal pregnancy.
- Vaginal bleeding after delivery, miscarriage or abortion that lasts longer than six weeks and shows no signs of stopping
- An enlarged uterus
- Pelvic pain or pressure
- Severe nausea and vomiting
- High blood pressure with headache and swelling of feet and hands early in pregnancy
- Anemia, which can cause fatigue, shortness of breath, dizziness, and a fast or irregular heartbeat
- Overactive thyroid
Signs of Choriocarcinoma
Choriocarcinoma is a cancerous form of GTD and is the most aggressive type of GTN, so it is important to contact your doctor if you experience any of the following symptoms after an abortion, miscarriage, ectopic pregnancy, or full-term pregnancy.
- Vaginal bleeding that lasts longer than six weeks and doesn’t show signs of slowing down
- Neurologic (brain) symptoms or cough, which could mean that the cancer has spread
What causes gestational trophoblastic disease?
Gestational trophoblastic disease (GTD) is a term for growths in the uterus that occur after conception. GTD is caused by conception (when sperm and egg join) and can develop during the early stages of a normal or ectopic pregnancy, or following a miscarriage or abortion.
What causes choriocarcinoma?
Choriocarcinoma is a cancerous form of GTD that most often develops from a molar pregnancy (also called hydatidiform mole or HM).
Why choose Penn?
As a world leader in cancer care and research, Penn Medicine offers cutting-edge treatments for gynecologic cancers, including gestational trophoblastic neoplasia (GTN). We focus on both your physical and emotional well-being to provide the best outcomes possible.
Our gynecologic cancer specialists work with Penn Fertility Care specialists to create customized gestational trophoblastic disease (GTD) treatment plans that can help you build a family after treatment. This is often called a “fertility sparing approach” or “medical management” of cancer and other diseases that can affect the reproductive organs.
We have more full-time, board-certified gynecologic oncologists than any other hospital in the Philadelphia region. Our entire team, including medical oncologists, pathologists, surgeons and radiation specialists, meets weekly to discuss joint treatment plans for each of our unique patients. However, GTD and its treatment can affect the whole body. That’s why we partner closely with specialists throughout the Penn system: This collaborative model lets us take on a greater complexity of care.
Frequently asked questions about gestational trophoblastic disease
GTD growths can be cancerous (malignant) or non-cancerous (benign). Most types of GTD are benign. However, some GTDs that start out benign can become malignant. Certain conditions can raise this risk.
GTD is very rare. In the United States, about 110 per 100,000 pregnancies develop into GTD.
Choriocarcinoma is very rare, affecting about 1 in 40,000 pregnancies. However, on average, one in 40 molar pregnancies will develop into choriocarcinoma.
If you have GTD, you will not be able to feel the tumor itself. However, you may feel pain or pressure in the abdomen or your uterus may become enlarged.
Most forms of GTD are benign (non-cancerous). However, cancerous forms, such as choriocarcinoma, can spread to other parts of the body if they are untreated.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
Related specialties
Patient stories
A grateful patient pays it forward to treat uterine cancers
Dalia Jakas credits her doctor with curing her uterine cancer without harming her quality of life. Now, she’s paying it forward for future patients.