Neoplasias trofoblásticas gestacionais: uma revisão de literatura

Abstract

Chorionic villi represent the main placental functional structure, being formed by villous cytotrophoblast, syncytiotrophoblast and extravillous cytotrophoblast. In case of differentiation and abnormal proliferation of trophoblastic cells, malignant conditions called Gestational Trophoblastic Neoplasms may occur, which are a rare group of placental diseases. The objective of the work is to expose the pathogenesis, the clinical, macroscopic and microscopic aspects of these diseases, in addition to bringing the indicated therapy in these cases. Gestational trophoblastic neoplasms include the invasive mole, choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor. The diagnosis can be made through different imaging tests and by detecting the hormone levels of human chorionic gonadotropin. Treatment is based on the anatomical staging system of the International Federation of Gynecology and Obstetrics together with the World Health Organization's prognostic index system. Low-risk diseases are treated with a single chemotherapeutic agent; for high risk and ultra high risk, the recommended therapy is with multiple agent protocols. Surgery is recommended in cases of placental site trophoblastic tumor and epithelioid trophoblastic tumor. Thus, for the best clinical outcome for patients, it is essential that health professionals have knowledge about these diseases so that they can guide care based on the characteristics of these disorders, even though clinical conditions are uncommon in clinical practice.