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F91The role of ultrasonography in the management of gestational trofoblastic disease: diagnostic, treatment and follow‐up modality
Author(s) -
Hrehorcak M,
Rob L.,
Kulovaný E.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00015-1-90.x
Subject(s) - medicine , radiology , hysterectomy , choriocarcinoma , curettage , ultrasonography , gestational trophoblastic disease , uterine perforation , perforation , ultrasound , pregnancy , surgery , gestation , population , genetics , materials science , environmental health , biology , family planning , metallurgy , punching , research methodology
Since hysterectomy is no longer considered standard procedure in the treatment of malignant gestational trofoblastic disease (GTD), ultrasonography plays a major role in the detection of the myometrial involvement. The Ultrasonography is standardly used as one of the main diagnostic tools when GTD is suspected. It seems that the size of the mola is no longer considered predictive marker for malignant change. We demonstrate the role of ultrasonography as an excellent method in the treatment of presumed GTD particularly in the evacuation of possibly invasive mole or choriocarcinoma. The specimen for the diagnosis is obtained securely under the ultrasound supervision enabling us to control the diagnostic curettage and to prevent the possible uterine wall perforation. Together with serum hCG levels US and Doppler analysis are useful tools in the monitoring of the tumor regression in the course of chemotherapy. We demonstrate that possible ultrasonographic features of the tumor like intramyometrial signals and hypoechogenic areas (representing mainly arteriovenous malformations) may remain in the long term follow up of successfully treated GTD with negative hCG serum levels. Concluding that monitoring of serum hCG is of major clinical interest in the treatment of GTD suggesting the limited interpretation value of ultrasonographic finding.