Cómo citar
1.
Espinoza Artavia A, Fernández Vaglio R, Solar del Valle T. Actualización en patología trofoblástica gestacional: mola hidatiforme y neoplasias. Rev.méd.sinerg. [Internet]. 1 de mayo de 2019 [citado 22 de diciembre de 2024];4(5):44 - 59. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/193
Resumen
La enfermedad trofoblástica gestacional está compuesta por una gama de patologías poco comunes asociadas al embarazo, que van desde benignas hasta malignas. Es importante realizar un diagnóstico oportuno mediante el uso de ultrasonido; apoyándose con estudios de laboratorio y gabinete, estudios histológicos y moleculares. En términos generales, el tratamiento de la enfermedad molar premaligna va a consistir en la evacuación uterina. El uso de quimioterapeúticos y de intervenciones quirúrgicas, en conjunto con el uso de radioterapia, podría llegar a tener un papel importante en el tratamiento tanto de estas como de las enfermedades trofoblásticas neoplásicas. La hormona gonadotropina coriónica humana es un biomarcador crucial para medir la progresión, respuesta a tratamiento y seguimiento de estas enfermedades. Gracias a la implementación de mejoras en el diagnóstico y tratamiento, la presentación clínica y morbilidad de las enfermedades ha cambiado conforme pasan los años.
Palabras clave
mola hidatiforme. enfermedad trofoblástica gestacional. neoplasias trofoblásticas. coriocarcinoma. tumor trofoblástico localizado en la placenta.
Citas
1. Durón R, Bolaños P. Enfermedad Trofoblástica Gestacional. Med Leg Costa Rica [Internet]. 2018 Marzo [citado 2019 Marzo 04]; 35(1):30-43. Disponible en: http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1409-00152018000100030&lng=en.
2. Tse K, Chan K, Tam K, Ngan H. Current management of gestational trophoblastic disease. Obstet Gynaecol Reprod Med [Internet]. 2015 Enero [citado 2019 Marzo 04]; 25(1):12-21. Disponible en: https://www-sciencedirect-com.ezproxy.sibdi.ucr.ac.cr/science/article/pii/S1751721414002012
3. Ngan H, Seckl M, Berkowitz R, Xiang Y, Golfier F, Sekharan P et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet [Internet]. 2018 Octubre [citado 2019 Marzo 04]; 143(Suppl 2): 79-85. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12615
4. Barber E, Soper J. Gestational Trophoblastic Disease. En: DiSaia P, Creasman W, Mannel R, McMeekin D, Mutch D, editores. Clinical Gynecologic Oncology [Internet]. 9na ed. Philadelphia:Elsevier; 2018 [citado 2019 Marzo 04]. p.163-189.e5. Disponible en: https://www-sciencedirect-com.ezproxy.sibdi.ucr.ac.cr/science/article/pii/B9780323400671000073#!
5. Brown J, Naumann R, Seckl M, Schink J. 15years of progress in gestational trophoblastic disease: Scoring, standardization, and salvage. Gynecol Oncol [Internet]. 2017 [citado 2019 Marzo 04]; 144(1):200-207. Disponible en: https://www.sciencedirect.com/science/article/pii/S0090825816313567
6. Salani R, Copeland L. Malignant Diseases and Pregnancy. En:Gabbe S, Niebyl J, Simpson J, Landon M, Galan H, Jauniaux E et al., editores. Obtetrics Normal and Problem Pregnancies. 7ma ed. Philadelphia:Elsevier; 2017. p.1070-1073.
7. Parker V, Tidy J. Current management of gestational trophoblastic disease. Obstet Gynaecol Reprod Med [Internet]. 2017 [citado 2019 Marzo 04]; 27(11):338-345. Disponible en: https://www.sciencedirect.com/science/article/pii/S1751721417301690
8. Melamed A, Gockley A, Joseph N, Sun S, Clapp M, Goldstein D et al. Effect of race/ethnicity on risk of complete and partial molar pregnancy after adjustment for age. Gynecol Oncol [Internet]. 2016 [citado 2019 Marzo 04]; 143(1):73-76. Disponible en: https://www.sciencedirect.com/science/article/pii/S009082581630988X
9. Shaaban A, Rezvani M, Haroun R, Kennedy A, Elsayes K, Olpin J et al. Gestational Trophoblastic Disease: Clinical and Imaging Features. Radiographics [Internet]. 2017 [citado 2019 marzo 04]; 37(2): 681-700. Disponible en: https://pubs.rsna.org/doi/10.1148/rg.2017160140?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
10. Johns J, Greenwold N, Buckley S, Jauniaux E. A prospective study of ultrasound screening for molar pregnancies in missed miscarriages. Ultrasound in Obstetrics and Gynecology. 2005;25(5):493-497.
11. Mangili G, Lorusso D, Brown J, Pfisterer J, Massuger L, Vaughan M et al. Trophoblastic Disease Review for Diagnosis and Management: A Joint Report From the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. Int J Gynecol Cancer [Internet]. 2014 [citado 2019 marzo 04]; 24(9 Suppl 3):S109-S116. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25341573 .
12. Khanna P. Enfermedad Trofoblástica Gestacional. Revista Médica De Costa Rica Y Centroamérica [Internet]. 2016 [citado 2019 Marzo 04]; 83(618):173-178. Disponible en: http://revistamedicacr.com/index.php/rmcr/article/view/192/177.
13. Kaur B, Sebire N. Gestational trophoblastic tumours and non-neoplastic trophoblastic lesions: morphology and immunocytochemistry to refine the diagnosis. Diagn Histopathol [Internet]. 2019 [citado 2019 Marzo 04]; 25(2):53-65. Disponible en: https://www.sciencedirect.com/science/article/pii/S1756231718302020
14. Kaur B, Short D, Fisher RA, Savage PM, Seckl MJ, Sebire NJ. Atypical placental site nodule (APSN) and association with malignant gestational trophoblastic disease; a clinicopathologic study of 21 cases. Int J Gynecol Pathol [Internet]. 2015 [cited 2019 Marzo 04]; 34(2):152–158. Disponible en: https://insights.ovid.com/pubmed?pmid=25675185
15. Goldstein D, Berkowitz R, Horowitz N. Diagnosis and Management of Gestational Trophoblastic Neoplasia. International Manual of Oncology Practice. 1era ed. Ramon Andrade de Mello, Álvaro Tavares, Giannis Mountzios., editores; 2015. p. 501-513.
16. Froeling F, Seckl M. Gestational Trophoblastic Tumours: An Update for 2014. Current Oncology Reports. 2014;16(11).
17. Berkowitz R, Goldstein D, Horowitz N. Management Options of Gestational Trophoblastic Disease. Current Obstetrics and Gynecology Reports. 2014;3(1):76-83.
18. Biscaro A, Braga A, Berkowitz R. Diagnosis, classification and treatment of gestational trophoblastic neoplasia. Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):42-51.
19. Gueye M, Ndiaye-Gueye M, Kane-Gueye S, Gassama O, Diallo M, Moreau J. Diagnosis, Treatment and Outcomes of Gestational Trophoblastic Neoplasia in a Low Resource Income Country. Int J MCH AIDS [Internet]. 2016 [citado 2019 marzo 04]; 5(2):112-118. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187643/
20. Santaballa A, García Y, Herrero A, Laínez N, Fuentes J, De Juan A et al. SEOM clinical guidelines in gestational trophoblastic disease (2017). Clinical and Translational Oncology. 2017;20(1):38-46.
21. Garcia-Sayre J, Castaneda A, Roman L, Matsuo K. Diagnosis and Management of Gestational Trophoblastic Disease. Handbook of Gynecology. 2017;:1-15.
22. Lawrie T, Alazzam M, Tidy J, Hancock B, Osborne R. First-line chemotherapy in low-risk gestational trophoblastic neoplasia (Review). Cochrane Database of systematic reviews. 2016;6.
23. Couder F, Massardier J, You B, Abbas F, Hajri T, Lotz J et al. Predictive factors of relapse in low-risk gestational trophoblastic neoplasia patients successfully treated with methotrexate alone. American Journal of Obstetrics and Gynecology. 2016;215(1):80.e1-80.e7.
24. Patni R. Gestational Trophoblastic Neoplasia: The Role of Surgery Cannot be Undermined!. Indian Journal of Gynecologic Oncology. 2017;15(4).
25. Eagles N, Sebire NJ, Short D, Savage PM, Seckl MJ, Fisher RA. Risk of recurrent molar pregnancies following complete and partial hydatidiform moles. Hum. Reprod [Internet]. 2015 [citado 2019 marzo 04]; 30(9): 2055–2063. Disponible en: https://academic.oup.com/humrep/article/30/9/2055/622581
2. Tse K, Chan K, Tam K, Ngan H. Current management of gestational trophoblastic disease. Obstet Gynaecol Reprod Med [Internet]. 2015 Enero [citado 2019 Marzo 04]; 25(1):12-21. Disponible en: https://www-sciencedirect-com.ezproxy.sibdi.ucr.ac.cr/science/article/pii/S1751721414002012
3. Ngan H, Seckl M, Berkowitz R, Xiang Y, Golfier F, Sekharan P et al. Update on the diagnosis and management of gestational trophoblastic disease. Int J Gynaecol Obstet [Internet]. 2018 Octubre [citado 2019 Marzo 04]; 143(Suppl 2): 79-85. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12615
4. Barber E, Soper J. Gestational Trophoblastic Disease. En: DiSaia P, Creasman W, Mannel R, McMeekin D, Mutch D, editores. Clinical Gynecologic Oncology [Internet]. 9na ed. Philadelphia:Elsevier; 2018 [citado 2019 Marzo 04]. p.163-189.e5. Disponible en: https://www-sciencedirect-com.ezproxy.sibdi.ucr.ac.cr/science/article/pii/B9780323400671000073#!
5. Brown J, Naumann R, Seckl M, Schink J. 15years of progress in gestational trophoblastic disease: Scoring, standardization, and salvage. Gynecol Oncol [Internet]. 2017 [citado 2019 Marzo 04]; 144(1):200-207. Disponible en: https://www.sciencedirect.com/science/article/pii/S0090825816313567
6. Salani R, Copeland L. Malignant Diseases and Pregnancy. En:Gabbe S, Niebyl J, Simpson J, Landon M, Galan H, Jauniaux E et al., editores. Obtetrics Normal and Problem Pregnancies. 7ma ed. Philadelphia:Elsevier; 2017. p.1070-1073.
7. Parker V, Tidy J. Current management of gestational trophoblastic disease. Obstet Gynaecol Reprod Med [Internet]. 2017 [citado 2019 Marzo 04]; 27(11):338-345. Disponible en: https://www.sciencedirect.com/science/article/pii/S1751721417301690
8. Melamed A, Gockley A, Joseph N, Sun S, Clapp M, Goldstein D et al. Effect of race/ethnicity on risk of complete and partial molar pregnancy after adjustment for age. Gynecol Oncol [Internet]. 2016 [citado 2019 Marzo 04]; 143(1):73-76. Disponible en: https://www.sciencedirect.com/science/article/pii/S009082581630988X
9. Shaaban A, Rezvani M, Haroun R, Kennedy A, Elsayes K, Olpin J et al. Gestational Trophoblastic Disease: Clinical and Imaging Features. Radiographics [Internet]. 2017 [citado 2019 marzo 04]; 37(2): 681-700. Disponible en: https://pubs.rsna.org/doi/10.1148/rg.2017160140?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
10. Johns J, Greenwold N, Buckley S, Jauniaux E. A prospective study of ultrasound screening for molar pregnancies in missed miscarriages. Ultrasound in Obstetrics and Gynecology. 2005;25(5):493-497.
11. Mangili G, Lorusso D, Brown J, Pfisterer J, Massuger L, Vaughan M et al. Trophoblastic Disease Review for Diagnosis and Management: A Joint Report From the International Society for the Study of Trophoblastic Disease, European Organisation for the Treatment of Trophoblastic Disease, and the Gynecologic Cancer InterGroup. Int J Gynecol Cancer [Internet]. 2014 [citado 2019 marzo 04]; 24(9 Suppl 3):S109-S116. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25341573 .
12. Khanna P. Enfermedad Trofoblástica Gestacional. Revista Médica De Costa Rica Y Centroamérica [Internet]. 2016 [citado 2019 Marzo 04]; 83(618):173-178. Disponible en: http://revistamedicacr.com/index.php/rmcr/article/view/192/177.
13. Kaur B, Sebire N. Gestational trophoblastic tumours and non-neoplastic trophoblastic lesions: morphology and immunocytochemistry to refine the diagnosis. Diagn Histopathol [Internet]. 2019 [citado 2019 Marzo 04]; 25(2):53-65. Disponible en: https://www.sciencedirect.com/science/article/pii/S1756231718302020
14. Kaur B, Short D, Fisher RA, Savage PM, Seckl MJ, Sebire NJ. Atypical placental site nodule (APSN) and association with malignant gestational trophoblastic disease; a clinicopathologic study of 21 cases. Int J Gynecol Pathol [Internet]. 2015 [cited 2019 Marzo 04]; 34(2):152–158. Disponible en: https://insights.ovid.com/pubmed?pmid=25675185
15. Goldstein D, Berkowitz R, Horowitz N. Diagnosis and Management of Gestational Trophoblastic Neoplasia. International Manual of Oncology Practice. 1era ed. Ramon Andrade de Mello, Álvaro Tavares, Giannis Mountzios., editores; 2015. p. 501-513.
16. Froeling F, Seckl M. Gestational Trophoblastic Tumours: An Update for 2014. Current Oncology Reports. 2014;16(11).
17. Berkowitz R, Goldstein D, Horowitz N. Management Options of Gestational Trophoblastic Disease. Current Obstetrics and Gynecology Reports. 2014;3(1):76-83.
18. Biscaro A, Braga A, Berkowitz R. Diagnosis, classification and treatment of gestational trophoblastic neoplasia. Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):42-51.
19. Gueye M, Ndiaye-Gueye M, Kane-Gueye S, Gassama O, Diallo M, Moreau J. Diagnosis, Treatment and Outcomes of Gestational Trophoblastic Neoplasia in a Low Resource Income Country. Int J MCH AIDS [Internet]. 2016 [citado 2019 marzo 04]; 5(2):112-118. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187643/
20. Santaballa A, García Y, Herrero A, Laínez N, Fuentes J, De Juan A et al. SEOM clinical guidelines in gestational trophoblastic disease (2017). Clinical and Translational Oncology. 2017;20(1):38-46.
21. Garcia-Sayre J, Castaneda A, Roman L, Matsuo K. Diagnosis and Management of Gestational Trophoblastic Disease. Handbook of Gynecology. 2017;:1-15.
22. Lawrie T, Alazzam M, Tidy J, Hancock B, Osborne R. First-line chemotherapy in low-risk gestational trophoblastic neoplasia (Review). Cochrane Database of systematic reviews. 2016;6.
23. Couder F, Massardier J, You B, Abbas F, Hajri T, Lotz J et al. Predictive factors of relapse in low-risk gestational trophoblastic neoplasia patients successfully treated with methotrexate alone. American Journal of Obstetrics and Gynecology. 2016;215(1):80.e1-80.e7.
24. Patni R. Gestational Trophoblastic Neoplasia: The Role of Surgery Cannot be Undermined!. Indian Journal of Gynecologic Oncology. 2017;15(4).
25. Eagles N, Sebire NJ, Short D, Savage PM, Seckl MJ, Fisher RA. Risk of recurrent molar pregnancies following complete and partial hydatidiform moles. Hum. Reprod [Internet]. 2015 [citado 2019 marzo 04]; 30(9): 2055–2063. Disponible en: https://academic.oup.com/humrep/article/30/9/2055/622581
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