A clinicopathological study of gestational trophoblastic diseases in a tertiary healthcare centre

Background: Gestational trophoblastic diseases are marked by abnormal proliferation of various trophoblastic cells during placentation. It includes hydatidiform mole, invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT). GTNs are among the rare human tumours that can be cured even in the presence of widespread dissemination. Aims of present study was to assess histomorphological features of GTD along with its clinical correlation. Methods: It was an observational cross-sectional study conducted in the Department of Pathology, at tertiary healthcare centre in South Gujarat over a period of 5 years from January 2019 to December 2023. Histological finding of all cases were recorded and clinical correlation done. Results: Out of 50 analysed cases of GTDs, 47 cases (94%) were Hydatiform mole and 3 cases (6%) were choriocarcinoma. The incidence of gestational trophoblastic diseases is found to be 1 in 799 pregnancies. Age ranged from 18-35 years. The most commonly affected age group was 20-25 years with 29 cases (58%). Most cases were presented in the first trimester. Most common clinical presentation was bleeding per vagina in 34 cases (68%) followed by abdominal pain. The majority of GTD cases belonged to 50,000 to <1,00,000 mlU/ml beta-HCG level. Conclusions: Hydatidiform mole is most prevalent gestational trophoblastic disease. Present study signifies the importance of routine histopathological examination of products of conception to rule out microscopic molar changes, since there is an higher incidence of molar pregnancies progressing to choriocarcinoma, a highly metastasizing neoplasm.