Ectopic Gestational Trophoblastic Disease: A 20‑Year Histopathological Review in a Tertiary Center

Abstract

Background: Gestational trophoblastic disease (GTD) is a group of proliferative disorders of the placental trophoblast. While the etiopathogenesis is not fully understood, this spectrum of diseases has varied histological appearances, with clinical behaviors ranging from benign to malignant. The burden of this group of lesions seems to be more in the developing countries. A high index of clinical suspicion, early laboratory confirmation of the diagnosis, and prompt treatment ensure total cures, even of malignant disease. These diseases, just like gestation itself, are known to occur in both intrauterine and extrauterine (ectopic) sites. Aim and Objectives: This study sought to determine the morphological pattern as well as the age and site distribution of the various forms of ectopic GTD histologically diagnosed in the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, between January 1993 and December 2012. It is a hospital‑based, retrospective review utilizing materials from the archives of the Department of Pathology, UBTH. The parameters studied include the specific histological diagnoses and the age and site distribution. Results: A total of 28 cases of ectopic GTDs were encountered. There were 17 cases (60.7%) and 8 cases (28.6%) of GTD found in the right and left fallopian tubes, respectively. Other sites of ectopic GTD were the left ovary (2 cases; 7.1%) and the right ovary (1 case; 3.5%). Partial mole was the most common (75.0%), followed by complete mole and invasive mole (10.7% each), and then choriocarcinoma (3.6%). The malignant: benign ratio was 1:27. Conclusion: Ectopic GTD, though still a relatively uncommon occurrence, should not be overlooked as a possibility in women with ectopic gestation, hence the need for histopathological and other ancillary evaluation of all ectopic conceptuses.