How is gestational trophoblastic disease diagnosed?

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If you have symptoms, a doctor may use several tests to see if you have gestational trophoblastic disease.

Once cancer of the fallopian tubes is suspected, you should be referred to a gynaecologic oncologist. This is a doctor who has specialist training in cancer of the female reproductive system.

Physical examination and medical history

An internal (pelvic) examination is usually the first test your doctor will do. The doctor will feel for any lumps or strange feeling in the shape or size of the uterus. They will also ask you about your medical history.

Ultrasound

The doctor may then do an ultrasound, a test that uses sound waves to find tumours.

During an ultrasound, high-energy sound waves are bounced off internal tissues or organs to make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram.

The test is non-invasive.

Blood test

Your doctor will likely order a blood test to look for high levels of a hormone called human chorionic gonadotrophin (hCG). hCG is present during normal pregnancy, but very high levels of the hormone can be a sign of gestational trophoblastic disease. It can be a sign of gestational trophoblastic disease if a woman is not pregnant and hCG is in the blood.

You may also have blood tests to assess your general health and to help make treatment decisions.

Further tests

If gestational trophoblastic neoplasm has been found, more tests will be done to find out if it has spread from inside the uterus to other parts of the body (see Staging). The results will help you and your doctor decide on the best treatment for you.

Staging is not done for hydatidiform moles.

You may have one or more of the following tests to help stage your cancer.

Chest x-ray

You may have a chest x-ray to check that your lungs and heart are healthy.

CT, MRI or PET scans

Computerised tomography (CT) or magnetic resonance imaging (MRI) scans allow doctors to see pictures of the organs and other structures (including tumours) in your body. They are usually done at a hospital or radiology clinic.

Your doctor may also ask for a positron emission tomography (PET) scan (a type of nuclear imaging test).