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Gestational Trophoblastic Disease

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Gestational trophoblastic disease (GTD) includes disorders of placental development (hydatidiform mole) and neoplasms of the trophoblast (choriocarcinoma, placental site trophoblastic tumor [PSTT], and epithelioid trophoblastic tumor).1;2 The recent classification of these lesions by the World Health Organization (WHO) clearly defines the different histologic forms of GTD (Table 4.1).

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References

  1. Silverberg SG, Kurman RJ. Tumors of the uterine corpus and gestational trophoblastic disease. Atlas of tumor pathology, 3rd series, Fascicle 3. Washington, DC: Armed Forces Institute of Pathology, 1992.

    Google Scholar 

  2. Shih I-M, Mazur MT, Kurman RJ. Gestational trophoblastic disease and related lesions. In: Kurman RJ, editor. Blaustein’s pathology of the female genital tract. 5th ed. New York: Springer-Verlag, 2002: 1193–1247.

    Google Scholar 

  3. Scully RE, Poulson H, Sobin LH. International Histological Classification and Typing of Female Genital Tract Tumours. Berlin: Springer-Verlag, 1994.

    Google Scholar 

  4. Hertig AT, Mansell H. Tumors of the female sex organs. Part I. Hydatidiform mole and choriocarcinoma. Atlas of Tumor Pathology, section 9, Fascicle 33. Washington, DC: Armed Forces Institute of Pathology, 1956.

    Google Scholar 

  5. Craighill MC, Cramer DW. Epidemiology of complete molar pregnancy. J Reprod Med 1984; 29:784–787.

    PubMed  CAS  Google Scholar 

  6. Womack C, Elston W. Hydatidiform mole in Nottingham: A 12-year retrospective epidemiological and morphological study. Placenta 1985; 6:93–106.

    PubMed  CAS  Google Scholar 

  7. Jeffers MD, O’Dwyer P, Curran B, Leader M, Gillan JE. Partial hydatidiform mole: A common but underdiagnosed condition. A 3-year retrospective clinicopathological and DNA flow cytometric analysis. Int J Gynecol Pathol 1993; 12:315–323.

    PubMed  CAS  Google Scholar 

  8. Bracken MB, Brinton LA, Hayashi K. Epidemiology of hydatidiform mole and choriocarcinoma. Epidemiol Rev 1984; 6:52–75.

    PubMed  CAS  Google Scholar 

  9. Grimes DA. Epidemiology of gestational trophoblastic disease. Am J Obstet Gynecol 1984; 150:309–318.

    PubMed  CAS  Google Scholar 

  10. Czernobilsky B, Barash A, Lancet M. Partial moles: A clinicopathologic study of 25 cases. Obstet Gynecol 1982; 59:75–77.

    PubMed  CAS  Google Scholar 

  11. Szulman AE, Surti U. The clinicopathologic profile of the partial hydatidiform mole. Obstet Gynecol 1982; 59:597–602.

    PubMed  CAS  Google Scholar 

  12. Szulman AE, Surti U. The syndromes of hydatidiform mole. I. Cytogenetic and morphologic correlations. Am J Obstet Gynecol 1978; 131:665–671.

    PubMed  CAS  Google Scholar 

  13. Szulman AE, Surti U. The syndromes of hydatidiform mole. II. Morphologic evolution of the complete and partial mole. Am J Obstet Gynecol 1978; 132:20–27.

    PubMed  CAS  Google Scholar 

  14. Keep D, Zaragoza MV, Hassold T, Redline RW. Very early complete hydatidiform mole. Hum Pathol 1996; 27:708–713.

    PubMed  CAS  Google Scholar 

  15. Sebire NJ, Rees H, Paradinas F, Seckl M, Newlands E. The diagnostic implications of routine ultrasound examination in histologically confirmed early molar pregnancies. Ultrasound Obstet Gynecol 2001; 18:662–665.

    PubMed  CAS  Google Scholar 

  16. Romero R, Horgan JG, Kohorn EI, Kadar N, Taylor KJW, Hobbins JC. New criteria for the diagnosis of gestational trophoblastic disease. Obstet Gynecol 1985; 66:553–558.

    PubMed  CAS  Google Scholar 

  17. Fukunaga M. Early partial hydatidiform mole: Prevalence, histopathology, DNA ploidy, and persistence rate. Virchows Arch 2000; 437:180–184.

    PubMed  CAS  Google Scholar 

  18. Bagshawe KD, Wilson H, Dublon P, Smith A, Baldwin M, Kardana A. Follow-up after hydatidiform mole: Studies using radioimmunoassay for urinary human chorionic gonadotrophin (hCG). J Obstet Gynaecol Br Commonw 1973; 80:461–468.

    PubMed  CAS  Google Scholar 

  19. Curry SL, Hammond CB, Tyrey L, Creasman WT, Parker RT. Hydatidiform mole: diagnosis, management, and long-term follow-up of 347 patients. Obstet Gynecol 1975; 45:1–8.

    PubMed  CAS  Google Scholar 

  20. Lurain JR, Brewer JI, Torok EE, Halpern B. Natural history of hydatidiform mole after primary evacuation. Am J Obstet Gynecol 1983; 145:591–595.

    PubMed  CAS  Google Scholar 

  21. Goto S, Yamada A, Ishizuka T, Tomoda Y. Development of postmolar trophoblastic disease after partial molar pregnancy. Gynecol Oncol 1993; 48:165–170.

    PubMed  CAS  Google Scholar 

  22. Berkowitz RS, Goldstein DP, Bernstein MR. Natural history of partial molar pregnancy. Obstet Gynecol 1983; 66:677–681.

    Google Scholar 

  23. Rice LW, Berkowitz RS, Lage JM, Goldstein DP, Bernstein MR. Persistent gestational trophoblastic tumor after partial hydatidiform mole. Gynecol Oncol 1990; 36:358–362.

    PubMed  CAS  Google Scholar 

  24. Zalel Y, Dgani R. Gestational trophoblastic disease following the evacuation of partial hydatidiform mole: A review of 66 cases. Eur J Obstet Gynecol Reprod Biol 1997; 71(1):67–71.

    PubMed  CAS  Google Scholar 

  25. Seckl MJ, Fisher RA, Salerno G, Rees H, Paradinas FJ, Foskett M et al. Choriocarcinoma and partial hydatidiform moles. Lancet 2000; 356(9223):36–39.

    PubMed  CAS  Google Scholar 

  26. Menczer J, Girtler O, Zajdel L, Glezerman M. Metastatic trophoblastic disease following partial hydatidiform mole: Case report and literature review. Gynecol Oncol 1999; 74:304–307.

    PubMed  CAS  Google Scholar 

  27. Gardner HAR, Lage JM. Choriocarcinoma following a partial hydatidiform mole—A case report. Hum Pathol 1992; 23:468–471.

    PubMed  CAS  Google Scholar 

  28. Matsui H, Iizuka Y, Sekiya S. Incidence of invasive mole and choriocarcinoma following partial hydatidiform mole. Int J Gynaecol Obstet 1996; 53:63–64.

    PubMed  CAS  Google Scholar 

  29. Cheung AN, Khoo US, Lai CY, Chan KYK, Cheng DKL, Chiu PM, et al. Metastatic trophoblastic disease after an initial diagnosis of partial hydatidiform mole. Genotyping and in situ hybridization analysis. Cancer 2004; 100:1211–1417.

    Google Scholar 

  30. Kajii T, Ohama K. Androgenetic origin of hydatidiform mole. Nature (London) 1977; 268:633–634.

    PubMed  CAS  Google Scholar 

  31. Wake N, Takagi N, Sasaki M. Androgenesis as a cause of hydatidiform mole. J Natl Cancer Inst 1978; 60:51–57.

    PubMed  CAS  Google Scholar 

  32. Kajii T, Kurashige H, Ohama K, Uchino F. XY and XX complete moles: Clinical and morphologic correlations. Am J Obstet Gynecol 1984; 150:57–64.

    PubMed  CAS  Google Scholar 

  33. Vassilakos P, Riotton G, Kajii T. Hydatidiform mole: Two entities. A morphologic and cytogenetic study with some clinical considerations. Am J Obstet Gynecol 1977; 127:167–170.

    PubMed  CAS  Google Scholar 

  34. Surti U, Szulman AE, O’Brien S. Dispermic origin and clinical outcome of three complete hydatidiform moles with 46, XY karyotype. Am J Obstet Gynecol 1982; 144:84–87.

    PubMed  CAS  Google Scholar 

  35. Surti U. Genetic concepts and techniques. In: Szulman AE, Buchsbaum HJ, eds. gestational Trophoblastic disease. New York: Springer-Verlag; 1987: 111–121.

    Google Scholar 

  36. Jacobs PA, Szulman AE, Funkhouser J, Matsuura JS, Wilson CC. Human triploidy: relationship between parental origin of the additional haploid complement and development of partial hydatidiform mole. Ann Hum Genet 1982; 46:223–231.

    PubMed  CAS  Google Scholar 

  37. Redline RW, Hassold T, Zaragoza MV. Prevalence of the partial molar phenotype in triploidy of maternal and paternal origin. Hum Pathol 1998; 29:505–511.

    PubMed  CAS  Google Scholar 

  38. Hemming JD, Quirke P, Womack C, Wells M, Elston CW, Bird CC. Diagnosis of molar pregnancy and persistent trophoblastic disease by flow cytometry. J Clin Pathol 1987; 40:615–620.

    PubMed  CAS  Google Scholar 

  39. Davis JR, Kerrigan DP, Way DL, Weiner SA. Partial hydatidiform moles: Deoxyribonucleic acid content and course. Am J Obstet Gynecol 1987; 157:969–973.

    PubMed  CAS  Google Scholar 

  40. Lage JM, Berkowitz RS, Rice LW, Goldstein DP, Bernstein MR, Weinberg DS. Flow cytometric analysis of DNA content in partial hydatidiform moles with persistent gestational trophoblastic tumor. Obstet Gynecol 1991; 77:111–115.

    PubMed  CAS  Google Scholar 

  41. Lage JM, Mark SD, Roberts DJ, Goldstein DP, Bernstein MR, Berkowitz RS. A flow cytometric study of 137 fresh hydropic placentas: Correlation between types of hydatidiform moles and nuclear DNA ploidy. Obstet Gynecol 1992; 79:403–410.

    PubMed  CAS  Google Scholar 

  42. Lawler SD, Fisher RA, Dent J. A prospective genetic study of complete and partial hydatidiform moles. Am J Obstet Gynecol 1991; 164:1270–1277.

    PubMed  CAS  Google Scholar 

  43. Lage JM, Weinberg DS, Yavner DL, Bieber FR. The biology of tetraploid hydatidiform moles: histopathology, cytogenetics, and flow cytometry. Hum Pathol 1989; 20:419–425.

    PubMed  CAS  Google Scholar 

  44. Fukunaga M, Ushigome S, Sugishita M. Application of flow cytometry in diagnosis of hydatidiform moles. Mod Pathol 1993; 6:353–359.

    PubMed  CAS  Google Scholar 

  45. Genest DR, Ruiz RE, Weremowicz S, Berkowitz RS, Goldstein DP, Dorfman DM. Do nontriploid partial hydatidiform moles exist? A histologic and flow cytometric reevaluation of nontriploid specimens. J Reprod Med 2002; 47:363–368.

    PubMed  Google Scholar 

  46. Fisher RA, Hodges MD, Rees HC, Sebire NJ, Seckl MJ, Newlands ES, et al. The maternally transcribed gene p57 (KIP2) (CDNK1C) is abnormally expressed in both androgenetic and biparental complete hydatidiform moles. Hum Mol Genet 2002; 11:3267–3272.

    PubMed  CAS  Google Scholar 

  47. Genest DR, Dorfman DM, Castrillon DH. Ploidy and imprinting in hydatidiform moles. Complementary use of flow cytometry and immunohistochemistry of the imprinted gene product p57KIP2 to assist molar classification. J Reprod Med 2002; 47:342–346.

    PubMed  CAS  Google Scholar 

  48. Castrillon DH, Sun D, Weremowicz S, Fisher RA, Crum CP, Genest DR. Discrimination of complete hydatidiform mole from its mimics by immunohistochemistry of the paternally imprinted gene product p57KIP2. Am J Surg Pathol 2001; 25:1225–1230.

    PubMed  CAS  Google Scholar 

  49. Fukunaga M. Immunohistochemical characterization of p57(KIP2) expression in early hydatidiform moles. Hum Pathol 2002; 33:1188–1192.

    PubMed  CAS  Google Scholar 

  50. Martin DA, Sutton GP, Ulbright TM, Sledge GW, Stehman FB, Ehrlich CE. DNA content as a prognostic index in gestational trophoblastic neoplasia. Gynecol Oncol 1989; 34:383–388.

    PubMed  CAS  Google Scholar 

  51. Fukunaga M. Flow cytometric and clinicopathologic study of complete hydatidiform moles with special reference to the significance of cytometric aneuploidy. Gynecol Oncol 2001; 81:67–70.

    PubMed  CAS  Google Scholar 

  52. Qiao S, Nagasaka T, Nakashima N. Numerous vessels detected by CD34 in the villous stroma of complete hydatidiform moles. Int J Gynecol Pathol 1997; 16:233–238.

    PubMed  CAS  Google Scholar 

  53. Conran RM, Hitchcock CL, Popek EJ, Norris HJ, Griffin JL, Geissel A, et al. Diagnostic considerations in molar gestations. Hum Pathol 1993; 24:41–48.

    PubMed  CAS  Google Scholar 

  54. Genest DR, Laborde O, Berkowitz RS, Goldstein DP, Bernstein MR, Lage J. A clinicopathologic study of 153 cases of complete hydatidiform mole (1980–1990)—Histologic grade lacks prognostic significance. Obstet Gynecol 1991; 78:402–409.

    PubMed  CAS  Google Scholar 

  55. Mosher R, Goldstein DP, Berkowitz R, Bernstein M, Genest DR. Complete hydatidiform mole. Comparison of clinicopathologic features, current and past. J Reprod Med 1998; 43:21–27.

    PubMed  CAS  Google Scholar 

  56. Paradinas FJ. The diagnosis and prognosis of molar pregnancy: The experience of the National Referral Centre in London. Int J Gynaecol Obstet 1998; 60Suppl 1:S57–S64.

    PubMed  Google Scholar 

  57. Coukos G, Makrigiannakis A, Chung J, Randall TC, Rubin SC, Benjamin I. Complete hydatidiform mole. A disease with a changing profile. J Reprod Med 1999; 44(8):698–704.

    PubMed  CAS  Google Scholar 

  58. Paradinas FJ, Browne P, Fisher RA, Foskett M, Bagshawe KD, Newlands E. A clinical, histopathological and flow cytometric study of 149 complete moles, 146 partial moles and 107 non-molar hydropic abortions. Histopathology 1996; 28:101–110.

    PubMed  CAS  Google Scholar 

  59. Kurman RJ. The morphology, biology, and pathology of intermediate trophoblast—a look back to the present. Hum Pathol 1991; 22:847–855.

    PubMed  CAS  Google Scholar 

  60. Montes M, Roberts D, Berkowitz RS, Genest DR. Prevalence and significance of implantation site trophoblastic atypia in hydatidiform moles and spontaneous abortions. Am J Clin Pathol 1996; 105:411–416.

    PubMed  CAS  Google Scholar 

  61. Genest DR. Partial hydatidiform mole: Clinicopathological features, differential diagnosis, ploidy and molecular studies, and gold standards for diagnosis. Int J Gynecol Pathol 2001; 20:315–322.

    PubMed  CAS  Google Scholar 

  62. Iyengar V, Roberts D, Lage J. Histopathologic study of triploid partial moles. Mod Pathol 1993; 6:74A.

    Google Scholar 

  63. Vejerslev LD, Dueholm M, Hassing N. Hydatidiform mole: cytogenetic marker analysis in twin gestation. Report of two cases. Am J Obstet Gynecol 1986; 155:614.

    PubMed  CAS  Google Scholar 

  64. Steller MA, Genest DR, Bernstein MR, Lage JM, Goldstein DP, Berkowitz RS. Clinical features of multiple conception with partial or complete molar pregnancy and coexisting fetuses. J Reprod Med 1994; 39:147–154.

    PubMed  CAS  Google Scholar 

  65. Steller MA, Genest DR, Bernstein MR, Lage JM, Goldstein DP, Berkowitz RS. Natural history of twin pregnancy with complete hydatidiform mole and coexisting fetus. Obstet Gynecol 1994; 83:35–42.

    PubMed  CAS  Google Scholar 

  66. Choi-Hong SR, Genest DR, Crum CP, Berkowitz R, Goldstein DP, Schofield DE. Twin pregnancies with complete hydatidiform mole and coexisting fetus: use of fluorescent in situ hybridization to evaluate placental X-and Y-chromosomal content. Hum Pathol 1995; 26:1175–1180.

    PubMed  CAS  Google Scholar 

  67. Lage JM, Driscoll SG, Yavner DL, Olivier AP, Mark SD, Weinberg DS. Hydatidiform moles. Application of flow cytometry in diagnosis. Am J Clin Pathol 1988; 89:596–600.

    PubMed  CAS  Google Scholar 

  68. Messerli ML, Parmley T, Woodruff JD, et al. Inter-and intra-pathologist variability in the diagnosis of gestational trophoblastic neoplasia. Obstet Gynecol 1987; 69:622–626.

    PubMed  CAS  Google Scholar 

  69. Javey H, Borazjani G, Behmard S, Langley FA. Discrepancies in the histological diagnosis of hydatidiform mole. Br J Obstet Gynaecol 1979; 86:480–483.

    PubMed  CAS  Google Scholar 

  70. Koenig C, Demopoulos RI, Vamvakas EC, Mittal KR, Feiner HD, Espiritu EC. Flow cytometric DNA ploidy and quantitative histopathology in partial moles. Int J Gynecol Pathol 1993; 12:235–240.

    PubMed  CAS  Google Scholar 

  71. Chew SH, Perlman EJ, Williams R, Kurman RJ, Ronnett BM. Morphology and DNA content analysis in the evaluation of first trimester placentas for partial hydatidiform mole (PHM). Hum Pathol 2000; 31:914–924.

    PubMed  CAS  Google Scholar 

  72. Paradinas FJ, Sebire NJ, Fisher RA, Rees HC, Foskett M, Seckl MJ, et al. Pseudo-partial moles: Placental stem vessel hydrops and the association with Beckwith-Wiedemann syndrome and complete moles. Histopathology 2001; 39(5):447–454.

    PubMed  CAS  Google Scholar 

  73. Sander CM. Angiomatous malformation of placental chorionic stem vessels and pseudo-partial molar placentas: Report of five cases. Pediatr Pathol 1993; 13:621–633.

    PubMed  CAS  Google Scholar 

  74. Zanetta G, Maggi R, Colombo M, Bratina G, Mangioni C. Choriocarcinoma coexistent with intrauterine pregnancy: Two additional cases and a review of the literature. Int J Gynecol Cancer 1997; 7:66–77.

    PubMed  CAS  Google Scholar 

  75. Schlaerth JB, Morrow CP, Rodriguez M. Diagnostic and therapeutic curettage in gestational trophoblastic disease. Am J Obstet Gynecol 1990; 162:1465–1471.

    PubMed  CAS  Google Scholar 

  76. Berkowitz RS, Desai U, Goldstein DP, Driscoll SG, Marean AR, Berstein MR. Pretreatment curettage—a predictor of chemotherapy response in gestational trophoblastic disease. Gynecol Oncol 1980; 10:39–43.

    PubMed  CAS  Google Scholar 

  77. Berkowitz RS, Birnholz J, Goldstein DP, Bernstein MR. Pelvic ultrasonography and the management of gestational trophoblastic disease. Gynecol Oncol 1983; 15:403–412.

    PubMed  CAS  Google Scholar 

  78. Elston CW, Bagshawe KD. The diagnosis of trophoblastic tumours from uterine curettings. J Clin Pathol 1972; 25:111–118.

    PubMed  CAS  Google Scholar 

  79. Takeuchi S. Nature of invasive mole and its rational treatment. Semin Oncol 1982; 9:181–186.

    PubMed  CAS  Google Scholar 

  80. Savage J, Subby W, Okagaki T. Adenocarcinoma of the endometrium with trophoblastic differentiation and metastases as choriocarcinoma: A case report. Gynecol Oncol 1987; 26:257–262.

    PubMed  CAS  Google Scholar 

  81. Pesce C, Merino MJ, Chambers JT, Nogales F. Endometrial carcinoma with trophoblastic differentiation. An aggressive form of uterine cancer. Cancer 1991; 68:1799–1802.

    PubMed  CAS  Google Scholar 

  82. Eckstein RP, Paradinas FJ, Bagshawe KD. Placental site trophoblastic tumour (trophoblastic pseudotumour): A study of four cases requiring hysterectomy, including one fatal case. Histopathology 1982; 6:211–226.

    PubMed  CAS  Google Scholar 

  83. Kurman RJ, Scully RE, Norris HJ. Trophoblastic pseudotumor of the uterus. An exaggerated form of “syncytial endometritis” simulating a malignant tumor. Cancer 1976; 38:1214–1226.

    PubMed  CAS  Google Scholar 

  84. Young RH, Scully RE. Placental site trophoblastic tumor: Current status. Clin Obstet Gynecol 1984; 27:248–258.

    PubMed  CAS  Google Scholar 

  85. Young RE, Kurman RJ, Scully RE. Proliferations and tumors of intermediate trophoblast of the placental site. Semin Diagn Pathol 1988; 5:223–237.

    PubMed  CAS  Google Scholar 

  86. Bower M, Paradinas FJ, Fisher RA, Nicholson SK, Rustin GJ, Begent RH, et al. Placental site trophoblastic tumor: Molecular analysis and clinical experience. Clin Cancer Res 1996; 2:897–902.

    PubMed  CAS  Google Scholar 

  87. Chang YL, Chang TC, Hsueh S, Huang KG, Wang PN, Liu HP, et al. Prognostic factors and treatment for placental site trophoblastic tumor-report of 3 cases and analysis of 88 cases. Gynecol Oncol 1999; 73:216–222.

    PubMed  CAS  Google Scholar 

  88. Feltmate CM, Genest DR, Goldstein DP, Berkowitz RS. Advances in the understanding of placental site trophoblastic tumor. J Reprod Med 2002; 47(5):337–341.

    PubMed  Google Scholar 

  89. Papadopoulos AJ, Foskett M, Seckl MJ, McNeish I, Paradinas FJ, Rees H, et al. Twenty-five years’ clinical experience with placental site trophoblastic tumors. J Reprod Med 2002; 47:460–464.

    PubMed  Google Scholar 

  90. Wright JD, Powell MA, Horowitz NS, Huettner PC, White F, Herzog TJ. Placental site trophoblastic tumor presenting with a pneumothorax during pregnancy. Obstet Gynecol 2002; 100(5 Pt 2):1141–1144.

    PubMed  Google Scholar 

  91. Oldt RJ, III, Kurman RJ, Shih I. Molecular genetic analysis of placental site trophoblastic tumors and epithelioid trophoblastic tumors confirms their trophoblastic origin. Am J Pathol 2002; 161:1033–1037.

    PubMed  CAS  Google Scholar 

  92. Shih IM, Kurman RJ. The pathology of intermediate trophoblastic tumors and tumor-like lesions. Int J Gynecol Pathol 2001; 20:31–47.

    PubMed  CAS  Google Scholar 

  93. Shih IM, Kurman RJ. Immunohistochemical localization of inhibin-alpha in the placenta and gestational trophoblastic lesions. Int J Gynecol Pathol 1999; 18:144–150.

    PubMed  CAS  Google Scholar 

  94. Feltmate CM, Genest DR, Wise L, Bernstein MR, Goldstein DP, Berkowitz RS. Placental site trophoblastic tumor: A 17-year experience at the New England Trophoblastic Disease Center. Gynecol Oncol 2001; 82:415–419.

    PubMed  CAS  Google Scholar 

  95. Gloor E, Dialdas J, Hurlimann J, Ribolzi J, Barrelet L. Placental site trophoblastic tumor (trophoblastic pseudotumor) of the uterus with metastases and fatal outcome. Am J Surg Pathol 1983; 7:483–486.

    PubMed  CAS  Google Scholar 

  96. Fukunaga M, Ushigome S. Metastasizing placental site trophoblastic tumor: An immunohistochemical and flow cytometric study of two cases. Am J Surg Pathol 1993; 17:1003–1010.

    PubMed  CAS  Google Scholar 

  97. Shih IM, Kurman RJ. Ki-67 labeling index in the differential diagnosis of exaggerated placental site, placental site trophoblastic tumor, and choriocarcinoma: A double immunohistochemical staining technique using Ki-67 and Mel-CAM antibodies. Hum Pathol 1998; 29:27–33.

    PubMed  CAS  Google Scholar 

  98. Shih IM, Kurman RJ. Epithelioid trophoblastic tumor: A neoplasm distinct from choriocarcinoma and placental site trophoblastic tumor simulating carcinoma. Am J Surg Pathol 1998; 22:1393–1403.

    PubMed  CAS  Google Scholar 

  99. Hamazaki S, Nakamoto S, Okino T, Tsukayama C, Mori M, Taguchi K, et al. Epithelioid trophoblastic tumor: Morphological and immunohistochemical study of three lung lesions. Hum Pathol 1999; 30:1321–1327.

    PubMed  CAS  Google Scholar 

  100. Ohira S, Yamazaki T, Hatano H, Harada O, Toki T, Konishi I. Epithelioid trophoblastic tumor metastatic to the vagina: an immunohistochemical and ultrastructural study. Int J Gynecol Pathol 2000; 19:381–386.

    PubMed  CAS  Google Scholar 

  101. Shen DH, Khoo US, Ngan HY, Ng TY, Chau MT, Xue WC, et al. Coexisting epithelioid trophoblastic tumor and choriocarcinoma of the uterus following a chemoresistant hydatidiform mole. Arch Pathol Lab Med 2003; 127:e291–e293.

    PubMed  Google Scholar 

  102. Mazur MT. Metastatic gestational choriocarcinoma. Unusual pathologic variant following therapy. Cancer 1989; 63:1370–1377.

    PubMed  CAS  Google Scholar 

  103. Silva EG, Tornos C, Lage J, Ordonez NG, Morris M, Kavanagh J. Multiple nodules of intermediate trophoblast following hydatidiform moles. Int J Gynecol Pathol 1993; 12:324–332.

    PubMed  CAS  Google Scholar 

  104. Coulson LE, Kong CS, Zaloudek C. Epithelioid trophoblastic tumor of the uterus in a postmenopausal woman: A case report and review of the literature. Am J Surg Pathol 2000; 24:1558–1562.

    PubMed  CAS  Google Scholar 

  105. Shih IM, Kurman RJ. p63 expression is useful in the distinction of epithelioid trophoblastic and placental site trophoblastic tumors by profiling trophobastic subpopulations. Am J Surg Pathol (In press).

    Google Scholar 

  106. Shih IM, Seidman JD, Kurman RJ. Placental site nodule and characterization of distinctive types of intermediate trophoblast. Hum Pathol 1999; 30:687–694.

    PubMed  CAS  Google Scholar 

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Mazur, M.T., Kurman, R.J. (2005). Gestational Trophoblastic Disease. In: Diagnosis of Endometrial Biopsies and Curettings. Springer, New York, NY. https://doi.org/10.1007/978-0-387-26321-2_4

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