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Sdn Bhd

Digital Slide Seminar

 

 

A/Prof Lyndal Anderson

Tissue Pathology and Diagnostic Oncology

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SYMP 1A 0D2: "Case studies in gestational trophoblastic disease"

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Case 1:

  • 38-year-old female. COVID-19 during pregnancy. Term delivery. Placental weight 534 grams.

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Case 2:

  • 52-year-old lady. 5 weeks of heavy PV bleeding. Cervical screening test normal. Urinary B-HCG normal but serum B-HCG 2,000,000 (probable hook effect). CT uterus 22 x 18 x 12 cm size with cystic spaces and blood products.

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Case 3:

  • 39-year-old female. Delivered health baby girl 3440g, 38+6/40, Apgars 9, 9. Very abnormal looking placenta. Family history of twins.

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Case 4:

  • 37-year-old female, 31/40, Placenta already 700grams. Innumerable tiny white nodules throughout the placental disc.

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Case 5:

  • 38-year-old female. Persistent B-HCG, 120,000: ?GTD. Very abnormal imaging, 88 x 86 x 65mm myometrial mass. No serosal perforation. No extrauterine disease.

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Case 6:

  • 31-year-old female GIP!, 37/40. Infant 2145 grams (low birth weight). Unremarkable pregnancy. Incidental finding on placental exam.

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Case 7:

  • 30-year-old female. Persistent low HCG 180. Very abnormal looking ultrasound presumed GTD. Would like to retain fertility. Failed tissue biopsies. Treated empirically with 8 cycles of chemo, no change to U/S.

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Case 8:

  • 33-year-old female. MIC 2020. Desires fertility, 2021? RPOC. Curettings: Proliferative endometrium, degenerate placental site nodule. Unsuccessful embryo transfer 2021, APSN. Unsuccessful embryo transfer 2022, APSN. Eventually agreed to hysterectomy. Hope to find GTD to justify surgery.

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