Appropriate Handling To Treat Malignant Trophoblast Disease?

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Does a patient diagnosed with PTG (Malignant Trophoblast Disease) with the last level of 78.56 still have to undergo chemotherapy ?? r nHistory: 28 June 2018 first curette, 12 July 2018 second curette, 18 July check bhcg and the result is 361 , 78. On the 27th of July, I checked the 2nd bhcg and the result rose to 365.56. On 11 August 2018, I checked again and the result dropped to 233.18. The chest X-ray showed fluid in the lungs, and the doctor recommended chemo. Because in my city there is no oncologist yet, I was referred to S city. In S city, I was checked again, namely on August 30 2018 and the result was 78.56.

1 Answer:

Hello Vhierman Syah ,, thank you for asking HealthReplies.com.


Basically PTG (Malignant Trophoblast Disease) is a disease that is a continuation of gestational trophoblast disease or the occurrence of abnormal and excessive growth in trophoblast cells during pregnancy. These trophoblast cells actually have a role in producing beta HGC in the blood, as well as the production of other pregnancy hormones which are useful in keeping the pregnancy growing and developing properly and normally. It's just that there is an abnormal growth of trophoblast cells that is found in some women, generally experienced in women who have experienced pregnancy wine or hydatid mole. This is what then makes the woman have Malignant Trophoblast Disease. Meanwhile, the exact cause of the malignant trophoblast disease is still unknown.


The basic principle of handling PTG is actually chemotherapy and surgery, with chemotherapy treatment being the first step taken so that afterwards surgery is carried out if there is a possibility of bleeding or has reached an advanced stage. Indications for chemotherapy treatment are based not only on the increase or decrease in the blood levels of beta HCG, but also other considerations such as:

increase in beta HCG after evacuation
HCG beta titres were very high despite evacuation
HCG beta did not decrease for 4 months after evacuation
a slow rise or fall in HCG beta after evacuation for 6 months
metastases to the lungs, vulva or vagina
the presence of metastasis to other organs such as the brain and liver
heavy vaginal or digestive system bleeding
the appearance of karyocarcinoma from histological examination

The earlier the diagnosis, the earlier the treatment is carried out, the better the prognosis, you should consult your oncologist again, considering that the lungs have seen a picture of fluid that has accumulated, which could possibly be metatasis into the lungs despite beta levels HCG has started to decline.


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