Donald P. Goldstein

Chorionic tumors, or gestational trophoblastic diseases, originate from placental tissues and are among the rare human tumors that can be cured even in the presence of widespread metastasis.14 Gestational trophoblastic diseases include a spectrum of interrelated tumors, including complete and partial hydatidiform mole, placental-site trophoblastic tumor, and choriocarcinoma, that vary in their propensity for local invasion and spreading. Although persistent gestational trophoblastic tumors develop most commonly after a molar pregnancy, they may follow any gestation. This article concentrates on recent advances in the understanding of the pathogenesis, natural history, and treatment of gestational trophoblastic diseases and describes our current . . .

A healthy 37-year-old woman presents at 10 weeks of pregnancy with vaginal bleeding. The level of serum human chorionic gonadotropin is 22,000 mIU per milliliter. Ultrasonography does not show an identifiable fetal heartbeat. The patient undergoes evacuation of the uterus; pathological examination indicates a complete molar pregnancy. How should this case be managed?