Trophoblastic tumors
Contents:
Description:
Trophoblastic tumors – group of the rare tumors developing from trophoblast cells these new growths are more often diagnosed for the women of young age who are in the active reproductive period (18-33 years).
Symptoms of Trophoblastic tumors:
Distinguish a vesical drift and a choriocarcinoma.
The Vesical Drift (VD) occurs at women of rather young age. At microscopic examination hypostasis and sliming of a stroma of fibers of chorion with a hyperplasia of both layers of a trophoblast come to light. At full PZ changes take all chorion, at partial — some of its part. On a morphological structure allocate simple, proliferating or destruiruyushchy (invasive) PZ.
Clinic. The most characteristic clinical sign — bloody allocations from a genital tract in terms of 10-12 weeks of pregnancy, after abortion or in a puerperal period.
Choriocarcinoma (HK) — the malignant tumor coming from epithelial cells of fibers of chorion. Develops against the background of pregnancy or from a vesical drift (as a rule, full). Arises at women aged up to 50 years. It is more often localized in a body of the womb, is more rare in the field of pathological implantation of fetal egg — in a uterine tube, an ovary, an abdominal cavity. The tumor arises from both layers of a trophoblast. Own has no stroma and vessels, but, having proteolytic properties, destroys blood vessels of a maternal organism and it is carried in the hematogenous way to lungs, a vagina, a liver and a brain. Early infection and a nekrotization is characteristic.
Clinic. It is shown by bloody allocations from a genital tract in any phase of a menstrual cycle, the progressing anemia, intoxication symptoms, pains in the bottom of a stomach. Often patients show the complaints caused by emergence of metastasises in lungs, a vagina, a brain, bodies of digestive tract.
Reasons of Trophoblastic tumors:
Trophoblastic tumors develop from elements of a trophoblast and produce the chorionic gonadotrophin (CG). They make 2-6% of all new growths of female generative organs. Development them is connected or with pathology of a chorial epithelium of fetal egg, or with disturbance of the immune and hormonal status in a maternal organism.
Treat risk factors of developing of trophoblastic tumors: age of the woman after 40 years, the low level of estrogen, and also insufficient receipt with food of vitamin A and animal fats.
Treatment of Trophoblastic tumors:
the ffektivnost of a surgical method is low and there correspond 40% of five-year survival of patients. It is shown at profuse uterine bleeding, a nekrotization of a new growth, tendency of a tumor to perforation, a choriocarcinoma of a placenta, resistance of a tumor to polychemotherapy, and also at the big sizes of a uterus — for the purpose of strengthening of effect of s of the subsequent medicinal treatment. The hysterectomy is made (at young women — without appendages). The local resection of a tumor is in some cases admissible.
The leading method of treatment of a choriocarcinoma is medicinal therapy. It is applied at the first stage of treatment at the vast majority of patients. At not metastatic form of a malignant trophoblastic disease and lack of adverse factors of the forecast the monochemotherapy is usually applied by a methotrexate or Dactinomycinum. In case of inefficiency of this type of treatment, and also at all patients with a metastatic form of a choriocarcinoma in the presence of adverse factors of the forecast the polychemotherapy of the first line is shown.
