Choriocarcinoma

Choriocarcinoma is a highly malignant tumor secondary to hydatidiform mole, abortion, or full-term delivery. Incidence ~0.0001-0.36%; few after ectopic pregnancy; mostly reproductive-age women. Rare primary ovarian choriocarcinoma in virgins. In the 1950s mortality was high; modern chemo dramatically improved prognosis. Mostly uterine; sometimes no uterine primary with only metastases present. Uterine choriocarcinoma forms single/multiple dark red/purple/brown wall nodules 2-10cm, hemorrhagic-necrotic; may project into cavity/infiltrate wall/serosa; friable, easily bleeding; tumor thrombi in parametrial veins; ovarian polycystic lutein cysts.

Common Symptoms

Abortion; bloody vaginal discharge; excessive vaginal bleeding

Causes and Pathogenesis

Nearly all related to pregnancy (mole/abortion/normal delivery); few from fertilized ovum directly; rare from teratoma trophoblast; tubal/abdominal pregnancy very rare. Gross/histology: uterine nodules 2-10cm hemorrhagic-necrotic, friable, parametrial tumor thrombi, lutein cysts. Histology: no connective-tissue stroma, only trophoblasts + blood clots/coagulative necrosis; no native vessels; tumor cells directly contact host blood; center has no tumor cells, periphery has more; no villous structure, only trophoblast sheets.

Treatment

Drug, surgery, radiation, supportive therapy

Preventive Measures

Eugenics/family planning; contraception; STD prevention; post-abortion tissue pathology. After cure: consolidation chemo 1-3 courses; weekly beta-HCG; re-consolidate at 3 months; then q6 months; stop if no recurrence in 2y. Fertile women: strict contraception 2y (condom + diaphragm). Benign trophoblastic tumor malignant transformation 10-20%; follow-up >=2y, long-term if possible.

Department to Visit

It is recommended to visit the Medical Oncology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.