Gestational trophoblastic neoplasia historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

In 6th century, Aetius of Amida, a physician at Justinian’s court came up with the term ‘hydatid’. Next mention of ‘mole’ is from 1276 when Margaret, Countess of Henneberg, delivered approximately 300 babies on Good Friday (the Friday before Easter Sunday). In 1827, Marie Anne Victoire Boivin, a Parisian midwife, proposed her findings of this condition in ‘Nouvelles Recherches de la Mole Visiculaire’ (News Searches of the Vesicular Mole). In 1840, William Wilton reported a case of invasive mole that was complicated by uterine perforation and fatal internal hemorrhage. In 1867, Richard von Volkmann, a German surgeon, also described a lesion resembling an invasive mole. In 1877, Hans Chiari, an Austrian pathologist, reported three cases of choriocarcinoma. He recognized the tumors as epithelial. In 1888, Max Sanger, a German obstetrician, proposed his theory that these tumors were actually sarcomas (‘deciduoma malignum’). In 1890, Pfeiffer, a student of Hans Chiari, re-examined Chiari’s cases and added a fourth case. He named them all ‘deciduoma malignum’. In 1891, Pestalozza from Italy, reported three cases of a malignant uterine tumor associated with pregnancy. He described these cases as ‘sarcoma hemorrhagicum sen infectiosum’.

• In 400 BC, Hippocrates is considered to be referring to gestational trophoblastic disease when he described ‘dropsy’ of the uterus.^[1]
• In 6th century, Aetius of Amida, a physician at Justinian’s court came up with the term ‘hydatid’.^[2]
• Next mention of ‘mole’ is from 1276 when Margaret, Countess of Henneberg, delivered approximately 300 babies on Good Friday (the Friday before Easter Sunday).^[2]
• In 1827, Marie Anne Victoire Boivin, a Parisian midwife, proposed her findings of this condition in ‘Nouvelles Recherches de la Mole Visiculaire’ (News Searches of the Vesicular Mole).^[2]
• In 1840, William Wilton reported a case of invasive mole that was complicated by uterine perforation and fatal internal hemorrhage.^[2]
• In 1867, Richard von Volkmann, a German surgeon, also described a lesion resembling an invasive mole.^[2]
• In 1877, Hans Chiari, an Austrian pathologist, reported three cases of choriocarcinoma. He recognized the tumors as epithelial.^[2]
• In 1888, Max Sanger, a German obstetrician, proposed his theory that these tumors were actually sarcomas (‘deciduoma malignum’).^[2]
• In 1890, Pfeiffer, a student of Hans Chiari, re-examined Chiari’s cases and added a fourth case. He named them all ‘deciduoma malignum’.^[2]
• In 1891, Pestalozza from Italy, reported three cases of a malignant uterine tumor associated with pregnancy. He described these cases as ‘sarcoma hemorrhagicum sen infectiosum’.
• In 1895, Felix Jacob Marchand, a German pathologist, reported two cases and he proposed that the tumors were epithelial. He traced their histogenesis to the coats of chorionic villi, hence the term ‘chorionepithelioma’.^[2]
• In 1903, John Teacher presented a detailed account of Marchand’s work along with two cases of his own and a literature review of 100 cases. He persuaded the Obstetrical Society of London that chorionepithelioma was derived from trophoblast.
• In 1910, Ewing coined the term ‘syncytial endometritis’ to describe the exaggerated reaction of the placental site following hydatidiform mole.^[2]

• Studies at the National Cancer Institute by Li et al (1956 – 1958) established the efficacy of methotrexate against trophoblastic tumors.^[2][3]

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