(GTN) a group of disorders characterized by persistence of *gestational trophoblastic disease, with abnormal placental development and very high levels of *human chorionic gonadotrophin (hCG). The chorionic villi are fluid-filled with vacuolation of the placenta and destruction of the normal stroma. GTN is rare in the UK, with a calculated incidence of 1/714 live births. It may develop after a molar pregnancy (see hydatidiform mole), a nonmolar pregnancy, or a live birth. The incidence after a live birth is estimated at 1/50,000. A malignant condition may develop (see choriocarcinoma) if the abnormal tissue is not completely removed and the risk of this is monitored by the fall in hCG levels. Choriocarcinoma complicates approximately 3% of complete moles, although in 50% of cases of choriocarcinoma there is no history of immediately preceding trophoblastic disease. It may also occur following a normal pregnancy. In the UK, there is an effective registration and treatment programme. The programme has achieved impressive results, with high cure (98–100%) and low chemotherapy (5–8%) rates.
diabetes or impaired glucose tolerance that is diagnosed during pregnancy (see glucose tolerance test). Women at increased risk of gestational diabetes include those with a personal history of the condition, obesity, or a family history of diabetes, and those who have had a previously unexplained stillbirth. In most cases gestational diabetes resolves at the end of the pregnancy, but such women are at increased risk of developing type 2 diabetes thereafter. It is treated by dietary control with or without insulin or metformin to avoid the fetal complications of *macrosomia and hypoglycaemia. See also pregestational diabetes.... gestational diabetes mellitus
(GTD) a group of disorders spanning the conditions of complete and partial molar pregnancies (see hydatidiform mole) through to the malignant conditions of invasive mole, *choriocarcinoma, and the very rare placental site trophoblastic tumour (PSTT). If there is any evidence of persistence of GTD, most commonly defined as a persistent elevation of *human chorionic gonadotrophin, the condition is described as *gestational trophoblastic neoplasia.... gestational trophoblastic disease
(PIN) cellular changes affecting the glans, prepuce, or penile shaft that precede the invasive stages of cancer of the penis. There are three stages (PIN I, II, or III) based on the degree of *dysplasia. The pathological features of PIN III indicate *carcinoma in situ, known as *erythroplasia of Queyrat and Bowen’s disease.... penile intraepithelial neoplasia
(PIN) abnormal cells in the prostate that are not cancer, but may be associated with cancer within the prostate. Typically, PIN will be found in prostate biopsies taken because levels of *prostate specific antigen are elevated. Multifocal high-grade PIN (HGPIN) on a prostate biopsy may indicate that another set of prostate biopsies should be taken in the future.... prostatic intraepithelial neoplasia
(VIN) premalignant disease of the vulva, which has histological features and terminology similar to those of *cervical intraepithelial neoplasia (CIN). Viral aetiological factors, such as HPV, are thought to be involved. The most common presenting symptom is itch, but VIN may be asymptomatic and detected only during treatment of preinvasive or invasive lesions of the cervix or lower genital tract.... vulval intraepithelial neoplasia
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