Regarding gestational trophoblastic disease (GTD),
1. Incomplete moles are more likely to undergo malignant change than the complete moles
2. GTD is almost always completely curable with preservation of fertility
3. Lymphnode involvement is a rare feature of choriocarcinoma
4. GTD usually shows low resistance blood flow
5. It is rare to have other metastasis in the absence of lung metastasis
Answers: F, T, T, T, T
Notes: GTD includes complete mole (46XX diploid), incomplete mole (triploid), invasive mole, choriocarcinoma and placental site trophoblastic tumour. 16% of complete and 0.5% of partial moles undergo malignant changes. Lymph node involvement in GTD raises a possibility of rare GTD, placental site trophoblastic tumor, as lymphnode involvement is rare in choriocarcinoma or invasive moles. Uterine volume has prognostic implications in GTD. The normal PI is more than 1.5 and in GTD, there is low resistance flow, leading to decrease in PI. PI indirectly measures tumor vascularity. With exception of vaginal metastasis, it is rare to have other metastsasis in the absence of lung metastasis. The lung metastasis are usually rounded, measuer up to 3 cm, rarely cavitate, can be miliary, may block pulmonary arteris and cause PE symptoms.
Reference: Allen SD et al. Radiology of gestational trophoblastic neoplasia. Clinical Radiology Volume 61, Issue 4, April 2006, Pages 301-313
