O&G Cases · Gynaecological oncology — gestational trophoblastic disease
Plateauing hCG after a molar pregnancy — diagnosis and treatment station
Management station for post-molar gestational trophoblastic neoplasia presented as a plateauing hCG: candidate excludes phantom hCG and pregnancy, stages and scores with the FIGO 2000 system, registers with the trophoblast centre, and agrees single-agent methotrexate-folinic acid. Includes assessor key, timeline and marking domains.
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Target exams
Station brief
Format. Management station, approximately 12 minutes. The examiner feeds new information; the candidate leads the assessment and decision-making.[2]
Candidate instruction. Make the diagnosis, exclude the mimics, stage and risk-score, register the woman, and agree the treatment. Verbalise the FIGO staging and the WHO score, the chemotherapy regimen with its schedule, and the counselling.[2]
References6ShowHide
- [1]FIGO Oncology Committee FIGO staging for gestational trophoblastic neoplasia 2000. FIGO Oncology Committee. Int J Gynaecol Obstet, 2002.PMID 12065144
- [2]Soper JT Gestational Trophoblastic Disease: Current Evaluation and Management. Obstet Gynecol, 2021.PMID 33416290
- [3]McNeish IA, Strickland S, Holden L, Rustin GJ, Foskett M, Seckl MJ, Newlands ES Low-risk persistent gestational trophoblastic disease: outcome after initial treatment with low-dose methotrexate and folinic acid from 1992 to 2000. J Clin Oncol, 2002.PMID 11919242
- [4]Jiang F, Guan CL, Jiao LZ, Xu T, Wan XR, Shi SS, et al. Efficacy and safety of biweekly single-dose actinomycin D versus multiday methotrexate in low-risk gestational trophoblastic neoplasia: a prospective multicenter randomized trial. Ann Oncol, 2025.PMID 40543844
- [5]Alifrangis C, Agarwal R, Short D, Fisher RA, Sebire NJ, Harvey R, Savage PM, Seckl MJ EMA/CO for high-risk gestational trophoblastic neoplasia: good outcomes with induction low-dose etoposide-cisplatin and genetic analysis. J Clin Oncol, 2013.PMID 23233709
- [6]Ngan HYS, Seckl MJ, Horowitz N, Cheung ANY, Braga A, Sekharan PK, Fridsten S, Garrett A, Yanaihara N, Wilailak S, Schmalfeldt B FIGO staging for gestational trophoblastic neoplasia: 2026 Int J Gynaecol Obstet, 2026.PMID 42473063