滋养细胞肿瘤（Trophoblastic tumor）.doc

滋养细胞肿瘤（Trophoblastic tumor） Gestational trophoblastic disease Hydatidiform mole: Completeness: all grapes inside, no normal embryonic tissue, no villi, no blood vessels. Self replicating diploids are paternal. The malignant transformation rate was 15%. Incomplete: in addition to grapes, there are also some embryonic tissues, villous, vascular, triploid. Clinical symptoms: 1. The uterus is larger than the menopause month; (there are grapes in it, that must be big). HCG rises. (+) diagnosis of hydatidiform mole. The contents of this post need to be answered before you can browse Luteinized cyst: the increase of HCG, accessories bag piece. Disappear spontaneously after curettage. Check: B: no no fetal bursa; vesicles; the Snow, or it can see direct diagnosis of hydatidiform mole. Treatment: once diagnosed, immediately curettage. Preferred suction curettage; Pay attention to reducing bleeding and perforation of the uterus; Once curettage is difficult, it can be performed curettage second times after 1W; Oxytocin is used after dilatation of the cervix and the beginning of aspiration; Each curettage must be sent to the sick. Luteinized cyst, generally do not need treatment. Prophylactic chemotherapy: 4 major: HCG large, large uterus, older ( 40), large diameter ( 6cm), as long as any of the 4 appeared on chemotherapy. Hysterectomy: high risk, 40A, no fertility requirement. Follow up for 2 years, contraception 1 years, tool contraception. Follow up: in addition to each HCG must be monitored, should be noted that there is no abnormal vaginal bleeding, with cough and hemoptysis and other metastases, and gynecological examination, pelvic ultrasound B and X-ray examination should also be repeated. Gestational trophoblastic tumor: Pathology： Invasive hydatidiform mole involving the myometrium of the uterus and having villi. Onset within 6 months. Choriocarcinoma: involving the myometrium, 3: no, no, no interstitial vascular villi. 6 months later. Clinical manifestation： No met