Diagnosis & Staging
Gestational Trophoblastic Neoplasia (GTN) is very rare.
The word "gestational" means "during pregnancy".
The placenta is the organ that gives oxygen and nutrients to a baby growing in a uterus. The trophoblast is a layer of cells that form the placenta.
Neoplasia is a growth of tissue that forms when cells grow more than they should or do not die when they should. These growths can be benign (not cancer) or malignant (cancer).
Gestational trophoblastic tumours form from the cells that would normally become the placenta during pregnancy.
- Your period is late.
- Your abdomen (belly) is swollen.
- If you are pregnant, the size of your uterus is larger or smaller than expected for that time in pregnancy.
- Your blood has high levels of a pregnancy hormone called human chorionic gonadotropin (HCG).
- Nausea (feeling queasy).
- A lot of vomiting.
- Pre-eclampsia (sudden increase in blood pressure during pregnancy).
- Overactive thyroid gland.
- Vaginal bleeding that may suggest a miscarriage.
- Passing abnormal tissue that looks like a "bunch of grapes" from your vagina, along with blood.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
Tests that may help diagnose GTN include:
- Pelvic exam
- Blood test: measures the amount of HCG in th blood.
- Ultrasound: to see GTN and if it has spread outside of your uterus.
- Chest x-ray: to see if GTN has spread to the lungs.
- Usually diagnosed in the first 12 weeks of pregnancy.
- Benign (not cancer), but it could turn into cancer.
- May be called a "molar pregnancy". However, a normal fetus (baby) does not form.
- Either complete or partial. In a normal conception, half of the baby's genes come from the male sperm and half from the female egg.
- Complete hydatidiform mole: an empty egg (no genetic material) is fertilized by a sperm and the complete genetic content is only from the sperm. A baby does not develop and a mass of tissue that looks like "a bunch of grapes" fills the uterus.
- Partial hydatidiform mole: one egg is fertilized by two sperm and there are three sets of chromosomes instead of the normal two sets. A baby starts to develop, but dies within a few weeks of pregnancy.
There is a higher chance of a complete hydatidiform mole turning into an invasive mole or choriocarcinoma, than the partial hydatidiform mole.
- These are cancer but they usually do not spread outside of the uterus.
- Happens when hydatidiform mole tissue in the uterus grows into the muscle layer (myometrium) of the uterus.
- An aggressive tumour that can grow quickly and spread to other parts of the body.
- A tumour develops from the tissue that started as a hydatidiform mole, or tissue that is still in the uterus after treatment for hydatidiform mole.
- Can also develop from tissue that is still in the uterus after an abortion or after the delivery of a baby.
- Very rare type of cancer.
- It starts in the place where the placenta was attached to the muscle of the uterus.
- Usually develop after a normal pregnancy but can develop after an abortion, miscarriage or removal of hydatidiform mole.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
- Stage 1: Disease is only in the uterus.
- Stage 2: Disease has spread outside of the uterus to other genital areas.
- Stage 3: Disease has spread to the lungs.
- Stage 4: Disease has spread to other parts of the body (distant metastasis).
For more information on staging, see our About Cancer