Trophoblastic tumors are a notoriously unpredictable group in which
metastasis may occur from histologically benign
tumors and cause death, whereas a histologically malignant
tumor may spontaneously disappear. Additional problems are created by the inability to accurately establish a diagnosis before abortion of molar tissue or development of
metastasis.In recent years
chemotherapy has dramatically improved the prognosis of patients with
choriocarcinoma. This fact, plus the importance of the time interval between onset of disease and the beginning of
chemotherapy, makes close follow-up of patients with
trophoblastic tumors imperative.Concepts of
therapy for
trophoblastic tumors are rapidly changing. Indications for
chemotherapy are broadening, especially in the areas of persistent and metastatic trophoblastic disease. As surgical intervention in the form of
hysterectomy is becoming less important, the reproductive capacity of these young women is being preserved. Astute diagnosis, appropriate
therapy and active life-long follow-up are the essentials in the management of patients with trophoblastic disease.