Gestational Trophoblastic Disease Screening & Diagnosis

Woman in lab scanning vials

Gynecologic cancer specialists at Penn Medicine's Abramson Cancer Center have a wealth of experience in diagnosing cancerous and noncancerous gestational trophoblastic disease (GTD), including choriocarcinoma.

Screening for Gestational Trophoblastic Disease

If you are showing signs of GTD, your doctor will want to talk about your health history, which may include questions about your reproductive history. You will also likely have a physical examination, including an internal pelvic examination.

In addition, we may recommend following tests:

  • CA-125 blood test: A blood test to determine if a tumor is present in your body.
  • Serum tumor marker test: A blood test to measure the amount of beta human chorionic gonadotropin (β-hCG) in the body. This is a hormone that the body makes during pregnancy.
  • Ultrasound exam: This uses sound waves to create a picture of what is happening in your body. When testing for GTD, ultrasounds can be done in two ways: externally and internally. An external ultrasound uses a small instrument placed over the belly, and an internal ultrasound (also called transvaginal sonography) uses a small instrument that is placed in the vagina.
  • Urinalysis: A test to examine the levels of certain substances in the urine.

Gestational Trophoblastic Disease Diagnosis

If GTD is found, additional tests may be done to see if it is cancerous or has spread to other parts of the body. This will also determine the cancer’s stage.

  • Chest X-ray: X-rays may be taken to see if cancer has spread to your lungs.
  • Abdominal/pelvic CT (computed tomography) scans: CT scans use X-rays to create cross-sectional pictures of your abdominal area. They are useful in showing the size of the tumor, if lymph nodes are swollen, and if the tumor has spread to other organs.
  • MRI (magnetic resonance imaging): An MRI uses radio waves and strong magnets to create cross-sectional pictures of your body.
  • Lumbar puncture: Also called a spinal tap, this is a procedure to collect a sample of spinal fluid to check for signs that cancer has spread to the spine or brain.

Stages of Gestational Trophoblastic Neoplasia

GTD is only staged if it is a cancer, or gestational trophoblastic neoplasia (GTN). It is most often diagnosed at an early stage.

  • Stage 1: Cancer is found only in the uterus.
  • Stage 2: Cancer is found outside of the uterus, in the genitals.
  • Stage 3: Cancer has spread to the lungs, and possibly the genitals.
  • Stage 4: Cancer has spread to the rest of the body.