www.thelancet.com Vol 374 July 4, 2009 7 trophoblastic tumour. These advances have become possible because of the ability to measure tumour load with hCG, diagnose hydatidiform mole in early pregnancy by ultrasound, and the ability to determine whether or not metastases are present on CT and MRI, together with greater understanding of the pathology and molecular physiology of trophoblastic neop...

A discussion of the classification of tro­ phoblastic neoplasms with clinical scien­ tists is of importance, for the work of those who direct pathology, biochemistry, en­ docrine and hematology laboratories is essential in the diagnosis and manage­ m ent of these neoplasms. Proper therapy requires the correct histopathologic diag­ nosis, monitoring of marrow, renal and marrow function and, m os...

Gestational trophoblastic neoplasia (GTN) is primarily a disease of women of reproductive age. In most instances, it is cured by surgical evacuation of the uterus, with persistent disease being very sensitive to chemotherapy. Hysterectomy, recommended for persistent chemotherapy-resistant uterine disease, may be unacceptable to the woman who wishes to maintain her fertility. Uterine resection o...

The advent of the radioimmunoassay of Beta subunit chorionic gonadotropin (BhCG) has eliminated a major problem in following the patient with gestational trophoblastic neoplasia (GTN). Whole hCG cross reacts with luteinizing hormone (hLH) causing difficulties when GTN patient titers fall to levels coincidental with pituitary levels of hLH. The use of the Beta subunit of hCG in radioimmunoassay ...