Choriocarcinoma

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Choriocarcinoma
Micrograph of choriocarcinoma, very high magnification
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Vaginal bleeding, abdominal pain, cough, hemoptysis
Complications Metastasis to lungs, brain, liver
Onset Typically after pregnancy
Duration Variable
Types N/A
Causes Gestational trophoblastic disease
Risks Prior molar pregnancy, age extremes in pregnancy
Diagnosis Beta-HCG levels, imaging studies
Differential diagnosis Ectopic pregnancy, molar pregnancy, germ cell tumor
Prevention N/A
Treatment Chemotherapy, surgery
Medication N/A
Prognosis Generally good with treatment
Frequency Rare
Deaths N/A


Choriocarcinoma - high mag
Choriocarcinoma - very high mag
Diagram showing stage 1 choriocarcinoma CRUK 190
Diagram showing stage 2 choriocarcinoma CRUK 207
Diagram showing stage 3 choriocarcinoma CRUK 220

Choriocarcinoma is a fast-growing cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. The placenta is the organ that develops during pregnancy to feed the fetus. Choriocarcinoma is a type of gestational trophoblastic disease (GTD), a group of conditions that occur when tumors develop in the cells that would normally form the placenta during pregnancy. Although rare, choriocarcinoma can be extremely aggressive and spread rapidly to other parts of the body.

Causes and Risk Factors

Choriocarcinoma most commonly follows a molar pregnancy, a pregnancy in which the placenta develops into an abnormal mass of cysts. However, it can also develop after a normal pregnancy, miscarriage, ectopic pregnancy, or abortion. Risk factors for developing choriocarcinoma include a previous molar pregnancy, especially if it was complete rather than partial, and age (women older than 35 and younger than 20 are at higher risk).

Symptoms

Symptoms of choriocarcinoma may include vaginal bleeding that is not related to a menstrual period, an enlarged uterus, and symptoms related to metastasis (spread of cancer) such as shortness of breath, cough, and hemoptysis (coughing up blood). Due to its aggressive nature, choriocarcinoma can quickly spread to other organs, including the lungs, liver, brain, and kidneys.

Diagnosis

Diagnosis of choriocarcinoma involves a combination of medical history, physical examination, ultrasound of the uterus, and blood tests to measure levels of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. High levels of hCG can indicate the presence of choriocarcinoma. In some cases, a biopsy of the uterus may be performed to confirm the diagnosis.

Treatment

Treatment for choriocarcinoma typically involves chemotherapy, which can be highly effective. Surgery may be required to remove the tumor if it is localized. In cases where the cancer has spread to other organs, a combination of chemotherapy and surgery may be necessary. The choice of treatment depends on the stage of the cancer and whether it has spread.

Prognosis

The prognosis for choriocarcinoma can vary widely depending on the stage of the cancer at diagnosis and how well it responds to treatment. With early detection and appropriate treatment, the prognosis is generally good, and many women can go on to have normal pregnancies in the future.

Prevention

There are no specific ways to prevent choriocarcinoma. However, regular medical check-ups and prompt attention to symptoms such as unusual vaginal bleeding can help in early detection and treatment, improving the chances of a favorable outcome.

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Contributors: Prab R. Tumpati, MD