Table 1. Clinical features of gestational trophoblastic disease ^{13– 26}.

Gestational trophoblastic Disease	Clinical Manifestations	Incidence	Risk Factors	Cellular Origin
Choriocarcinoma	Irregular vaginal bleeding, cough, hemoptysis, headache, vomiting, convulsions, purple blue vaginal nodules, enlarged uterus, ovarian flavin cyst, intraperitoneal hemorrhage, high hCG levels	1 in 40,000 pregnancies	Age, deep myometrial invasion, tumor size, molar pregnancy, smoking, spontaneous miscarriage, ectopic pregnancy, site of metastases, disease duration, hCG level, stage	Villous trophoblast
Hydatidiform mole (complete)	Karyotype of 46XX, 46XY, diffuse villous enlargement with hydropic changes. varying atypia of trophoblast, absence of fetal tissue and villous capillaries, uterine enlarge , high hCG levels for gestational age, hypertension and hyperemesis gravidarum, abnormal bleeding, ovarian theca lutein cysts	0.57–1.1 per 1000 pregnancies	Age, ethnicity, and genetic basis, spontaneous miscarriage, nutrient, family history	Villous trophoblast
Hydatidiform mole (partial)	Karyotype of 69XXX, 69XXY or 69XYY, placental villi are focal edema and denatured that vary in size and shape, trophoblastic cells proliferate, fetal tissue is present, few full-term babies born, uteri are small for gestational age, low hCG level for gestational age, few medical complications	0.57–1.1 per 1000 pregnancies	Age, ethnicity, and genetic basis, spontaneous miscarriage, nutrient status, family history	Villous trophoblast
Epithelioid trophoblastic tumor	Abnormal vaginal bleeding	1 in 100,000 pregnancies	Stage, family history, deep invasion, tumor size	Intermediate trophoblast
Placental site trophoblastic tumor	Abnormal vaginal bleeding, trophoblastic infiltration confined to the endometrium and myometrium, hCG may be absent, resistant to chemotherapy	1 in 100,000 pregnancies	Age, deep invasion, tumor size, mitotic rate, disease stage, hCG level	Intermediate trophoblast