Gestationsbedingte Trophoblasterkrankungen

Kernaussagen

Die gestationsbedingten Trophoblasterkrankungen (GTD) sind eine klinisch und morphologisch sehr heterogene Gruppe von pathologischen Veränderungen, die charakterisiert ist durch eine Fehldifferenzierung und/oder Proliferation von Trophoblastgewebe. Das Spektrum reicht von Befunden ohne Krankheitswert über benigne Erkrankungen bis hin zu sehr aggressiven Neoplasien. Als wichtigste Risikofaktoren gelten das mütterliche Alter und vorausgegangene hydatidiforme Molenschwangerschaften; die elterliche Blutgruppenkonstellation und die Einnahme oraler Kontrazeptiva stellen weitere Risikofaktoren dar.

Symptomatisch äußern sich GTD mit den klassischen Zeichen einer physiologischen Frühschwangerschaft sowie häufig durch vaginale Blutungen, Anämie oder Druck bzw. Schmerzen im Unterbauch.

Die Prognose von gestationellen trophoblastären Neoplasien ist sehr gut. Alle Patientinnen mit einer Low-Risk-Erkrankung können mit einer Heilung rechnen. Das Überleben für High-Risk-Patientinnen beträgt derzeit 86 %. Das Gesamtüberleben ist ca. 98 %. Trotzdem bleiben viele Fragen im Bereich dieser seltenen Erkrankungen offen.

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