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Gestational trophoblastic disease: Pathology

Rebecca N Baergen, MD
Section Editors
Barbara Goff, MD
Don S Dizon, MD, FACP
Deputy Editor
Sandy J Falk, MD, FACOG


Gestational trophoblastic disease comprises a heterogeneous group of related lesions arising from abnormal proliferation of trophoblast of the placenta. The pathogenesis of gestational trophoblastic disease is unique, because the maternal lesions arise from fetal, not maternal, tissue.

The histopathology of gestational trophoblastic disease is discussed here. The epidemiology, clinical manifestations, diagnosis, and treatment of hydatidiform moles and malignant gestational trophoblastic disease are reviewed separately. (see "Hydatidiform mole: Epidemiology, clinical features, and diagnosis" and "Hydatidiform mole: Management" and "Initial management of low-risk gestational trophoblastic neoplasia"). Differential diagnosis on clinical grounds may be difficult in a patient with an elevated serum beta-human chorionic gonadotropin (hCG) with abnormal tissue in the uterus on ultrasonography and therefore, histology is necessary for definitive diagnosis.


Gestational trophoblastic disease (GTD) – Lesions characterized by abnormal proliferation of trophoblast of the placenta. This category is comprised of benign, nonneoplastic lesions, including placental site nodule, exaggerated placental site, and hydatidiform mole.

Gestational trophoblastic neoplasia (GTN) – Gestational neoplasms include: choriocarcinoma, placental site trophoblastic tumor, epithelioid trophoblastic tumor, and invasive mole. In the absence of tissue for a definitive histopathologic diagnosis, disease diagnosed as a result of persistent elevation of human chorionic gonadotropin (hCG) after evacuation of a molar pregnancy is termed GTN.


Most, but not all, gestational trophoblastic disease (GTD) produces the beta subunit of human chorionic gonadotropin (hCG). Chromosomal abnormalities are characteristic of some GTD subtypes such as molar pregnancies; assessment of DNA content enhances the diagnostic accuracy of histologic diagnosis [1,2]. (See 'Genetics' below.)

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Literature review current through: Dec 2017. | This topic last updated: Mar 19, 2017.
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