Create multiple-choice questions covering gestational trophoblastic neoplasia.

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Last updated: September 13, 2026 • View editorial policy

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Multiple-Choice Questions on Gestational Trophoblastic Neoplasia

Classification and Epidemiology

Question 1: What percentage of gestational trophoblastic disease (GTD) is comprised of hydatidiform moles?

  • A. 50%
  • B. 65%
  • C. 80%
  • D. 95%

Answer: C 1

Question 2: What is the incidence of GTD in the United States?

  • A. 1 in 500 pregnancies
  • B. 1 in 1,000 pregnancies
  • C. 1 in 2,000 pregnancies
  • D. 1 in 5,000 pregnancies

Answer: B 1

Question 3: Which malignant forms are included under gestational trophoblastic neoplasia (GTN)?

  • A. Invasive mole, choriocarcinoma, PSTT, ETT
  • B. Complete mole, partial mole, invasive mole
  • C. Choriocarcinoma, complete mole, PSTT
  • D. Invasive mole, partial mole, ETT

Answer: A 1

Genetics and Pathogenesis

Question 4: What is the most common karyotype of a complete hydatidiform mole?

  • A. 69,XXX (triploid)
  • B. 46,XX (diploid, both paternal)
  • C. 46,XY (diploid, maternal and paternal)
  • D. 45,X (monosomy X)

Answer: B 1

Question 5: How does a complete mole most commonly arise?

  • A. Fertilization of an ovum with intact nucleus by two sperm
  • B. Fertilization of an empty ovum by a single sperm with subsequent duplication
  • C. Fertilization of an ovum by three sperm
  • D. Parthenogenesis

Answer: B 1

Question 6: Which statement is TRUE regarding partial hydatidiform moles?

  • A. They never contain fetal tissue
  • B. They can contain fetal tissue
  • C. They have higher malignant potential than complete moles
  • D. They always progress to choriocarcinoma

Answer: B 1

Risk of Malignant Transformation

Question 7: What percentage of complete moles develop postmolar GTN?

  • A. 1-5%
  • B. 5-10%
  • C. 15-20%
  • D. 30-40%

Answer: C 1

Question 8: What percentage of partial moles develop postmolar GTN?

  • A. 1-5%
  • B. 10-15%
  • C. 15-20%
  • D. 25-30%

Answer: A 1

Question 9: Approximately what percentage of invasive moles metastasize?

  • A. 5%
  • B. 15%
  • C. 30%
  • D. 50%

Answer: B 1

Choriocarcinoma

Question 10: What percentage of choriocarcinomas arise following a hydatidiform mole?

  • A. 25%
  • B. 50%
  • C. 75%
  • D. 90%

Answer: B 1

Question 11: What percentage of complete moles progress to choriocarcinoma?

  • A. 2-3%
  • B. 5-7%
  • C. 10-12%
  • D. 15-20%

Answer: A 1

Question 12: Which histologic feature is characteristic of choriocarcinoma?

  • A. Presence of chorionic villi
  • B. Absence of chorionic villi
  • C. Minimal hCG production
  • D. Absence of hemorrhage

Answer: B 1

Intermediate Trophoblastic Tumors

Question 13: What is the incidence of placental site trophoblastic tumor (PSTT)?

  • A. 1 in 10,000 pregnancies
  • B. 1 in 50,000 pregnancies
  • C. 1 in 100,000 pregnancies
  • D. 1 in 500,000 pregnancies

Answer: C 1

Question 14: What percentage of all GTN cases do intermediate trophoblastic tumors (PSTT and ETT) represent?

  • A. 1%
  • B. 5%
  • C. 10%
  • D. 15%

Answer: A 1

Question 15: Which cell type does PSTT arise from?

  • A. Villous trophoblast
  • B. Interstitial trophoblast at the placental implantation site
  • C. Chorionic-type intermediate trophoblast
  • D. Syncytiotrophoblast

Answer: B 1

Question 16: Which cell type does epithelioid trophoblastic tumor (ETT) arise from?

  • A. Villous trophoblast
  • B. Interstitial trophoblast
  • C. Chorionic-type intermediate trophoblast
  • D. Cytotrophoblast

Answer: C 1

Treatment - Low-Risk GTN

Question 17: What is the cure rate for GTN when treated adequately?

  • A. 70-80%
  • B. 80-90%
  • C. 90-95%
  • D. Approaching 100%

Answer: D 1

Question 18: What is the complete response rate to secondary dactinomycin in patients with methotrexate-resistant low-risk GTN?

  • A. 50%
  • B. 60%
  • C. 75%
  • D. 90%

Answer: C 1

Question 19: What was the overall survival rate for patients requiring third-line treatment after methotrexate and dactinomycin failure?

  • A. 75%
  • B. 85%
  • C. 95%
  • D. 100%

Answer: D 1

Treatment - High-Risk GTN

Question 20: What is the most commonly used initial chemotherapy regimen for high-risk GTN?

  • A. BEP (bleomycin, etoposide, cisplatin)
  • B. EMA/CO (etoposide, methotrexate, dactinomycin/cyclophosphamide, vincristine)
  • C. CHAMOCA
  • D. Single-agent methotrexate

Answer: B 1

Question 21: What is the complete response rate to EMA/CO in high-risk GTN?

  • A. 40-50%
  • B. 50-60%
  • C. 62-78%
  • D. 85-95%

Answer: C 1

Question 22: What is the long-term survival rate with EMA/CO for high-risk GTN?

  • A. 65-75%
  • B. 75-85%
  • C. 85-94%
  • D. 95-100%

Answer: C 1

Question 23: What percentage of postmolar GTN cases are classified as high-risk?

  • A. 2%
  • B. 6%
  • C. 15%
  • D. 25%

Answer: B 1

FIGO Staging and Risk Scoring

Question 24: High-risk GTN is defined as which of the following?

  • A. FIGO stage I with score ≥7
  • B. FIGO stages II-III with score ≥7, or stage IV
  • C. Any FIGO stage with score ≥5
  • D. FIGO stage IV only

Answer: B 1

Question 25: What is the approximate cure rate for high-risk GTN with multimodal therapy?

  • A. 70%
  • B. 80%
  • C. 90%
  • D. 95%

Answer: C 1

Monitoring and Follow-up

Question 26: What is the primary tumor marker used for monitoring GTN?

  • A. CA-125
  • B. AFP (alpha-fetoprotein)
  • C. hCG (human chorionic gonadotropin)
  • D. CEA (carcinoembryonic antigen)

Answer: C 1, 2

Question 27: According to the 2025 global consensus guidelines, how many expert GTD clinicians from how many countries participated in formulating the guidelines?

  • A. 35 clinicians from 20 countries
  • B. 45 clinicians from 25 countries
  • C. 53 clinicians from 31 countries
  • D. 60 clinicians from 35 countries

Answer: C 3

Prognosis and Outcomes

Question 28: Which factors are associated with poorer outcomes in high-risk GTN?

  • A. Lung metastases only
  • B. Vaginal metastases only
  • C. Liver and brain metastases
  • D. Bone metastases only

Answer: C 1

Question 29: What is the survival rate for patients with stage IV GTN?

  • A. 50%
  • B. 60%
  • C. 70%
  • D. 80%

Answer: C 1

Management Principles

Question 30: According to current guidelines, where should all cases of GTN be discussed?

  • A. Local tumor board only
  • B. Multidisciplinary cancer case conference and registered in centralized database
  • C. With the primary obstetrician only
  • D. Regional oncology meeting only

Answer: B 4

These questions comprehensively cover the epidemiology, pathogenesis, classification, diagnosis, staging, treatment, and prognosis of gestational trophoblastic neoplasia based on the most recent international guidelines 3, 1, 5, 4.

References

1
Guideline

gestational trophoblastic neoplasia, version 2.2019, nccn clinical practice guidelines in oncology.

Journal of the National Comprehensive Cancer Network : JNCCN, 2019

4
Research

Guideline No. 408: Management of Gestational Trophoblastic Diseases.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2021

5
Research

FIGO staging for gestational trophoblastic neoplasia: 2026.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026

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