Morphological Pattern of Gestational Trophoblastic Disease in the University of Benin Teaching Hospital, Benin City: A Twenty Year Review (1993 – 2012)

Abstract

Background: Gestational trophoblastic disease (GTD) is a spectrum of proliferative disorders of the placental trophoblast with a range of histological appearance and clinical behaviour. Although its aetiopathogenesis is as yet incompletely understood, it is well established that early detection and prompt treatment lead to the preservation of normal health and fertility. Aim and Objectives: This study sought to determine the morphological pattern as well as the age and site distribution of the various forms of GTD histologically diagnosed in the University of Benin Teaching Hospital, Benin City, between January 1993 and December 2012. It is a hospital based, retrospective review utilizing materials from the archives of the Department of Morbid Anatomy, University of Benin Teaching Hospital. Results: A total of 168 cases of GTD were encountered, and 103 (61.3%) of these were seen in the latter 10 years, reflecting a rise in incidence in recent years. The age range was 15 – 62 years, and the mean age was 31.27 ± 7.36 years. GTD was found to be less common at the extremes of reproductive age, with the peak prevalence being in the third and fourth decades. Partial mole was commonest (52.4%), followed by complete mole (25.0%) and choriocarcinoma (19.0%). The ratio of the benign to malignant lesions was 4:1. The uterus was the commonest site of GTD accounting for 83.3% of cases, while 16.6% of cases were distributed among ectopic sites. There was failure to clinically or grossly identify molar vesicles in 80.6% of cases of hydatidiform mole; this highlights the relevance of histopathological examination of products of conception of both intrauterine and ectopic gestation. Conclusion: The prevalence of GTD appears to have been rising in this environment in the recent years.