Session Speaker

GTN in Perimenopause and Menopause – Treatment and Outcome
Branka Nikolic and Ana Mitrovic
Serbia

Gestational Trophoblastic Neoplasms (GTN) are a group of diseases which are known as fertilisation disorders and may appear as complete hydatidiform mole, mole partialis, invasive mole, placental site trophoblastic tumor, and choriocarcinoma. Malignant disease precedes in approximately 50% of patients. All cases of GTN must be registered. The follow up programme period may last 6 months to 2 years until three sequential beta hCG values are negative (1.2.3.4). The risk of repeated GTN is low but the patient has to be informed that risk is 1:74 (1). GTN can appear even in perimenopausal or menopausal women. That is the reason why each rapid enlargement of uterus especially with uterine bleeding followed with multiple cystic formations (grape like cysts) needs a serious examination on GTN. The patient can complain of nausea, vomiting, painful breasts, hyperthyroidism or hypertension. Legal abortion can precede GTN in perimenopausal women. In the great number of women with GTN, the last pregnancy was 5 or more than 5 years before GTN was diagnosed. In 1999(March-June), unpowerishment Uranium was used during war in Former Yugoslavia. Potential effect on increased number of malignancies including malignant GTN could be analyzed after collecting data from the whole territory of Serbia and countries in the region in the next years. Among all GTN patients hospitalised in our Clinic from 1999 until 2009, nine patients were perimenopausal or menopausal with confirmed GTN with low clinical score. They were clinically, and through laboratory ultrasonographically, examined and staged according to FIGO 2002 recommendations (2.4). Malignant GTN was hystologically confirmed in all cases.