Ján Vojtaššák, Branislav Vojtaššák
Gestational trophoblastic disease is a very heterogenic group of lesions from benign to malignant ones. It is a unique form of pathologic embryonic development caused by the absence of the whole or only of a part of maternal nuclear genome. Many benign and malignant forms belong to this disease. The benign form usually arises in the moment of fertilization or in the first hours of existence, with the exception of familial recurrent biparental hydatidiform moles. The reason to it is the unavailability of specific genetic information coded by maternal nuclear genome needed for development of an embryo. This information is absent or chemically so modified, that it is not available. Majority of malignant forms arises from previous molar pregnancy what could be proved by genetic analysis. But they arise also after physiological pregnancy, spontaneous abortion or ectopic pregnancy. Trophoblast cells with the ability of controlled invasion into the surrounding tissue at the place of implantation as well as their transport by blood vessels, usually into the lungs of pregnant woman are the reason. The accidental subsequent mutations in the system of the cell cycle regulation of such trophoblast cells could start the process of malignant transformation resulting into the gestational trophoblastic neoplasia and explain also the specific features of therapy.