Gestational choriocarcinoma

Gestational choriocarcinoma is a malignant trophoblastic tumour arising from any gestational event during pregnancy in the reproductive female. Women with gestational choriocarcinoma may present with abnormal vaginal bleeding, persistent markedly elevated βhCG, or a history of prior pregnancy. Most patients develop gestational choriocarcinoma shortly after gestational anomalies, but pathology may occur after a long latency of years. It may occur during pregnancy. Often, it happens after a growth of some sort in the womb (pregnancy, tumor, mole, cyst)[1]

Diagnosis

Grossly, a red hemorrhagic mass is seen in the uterus, though it may vary in size. Often, diagnosis is presumptive, and based on clinical findings and the identification of a malignant trophoblast. One prevalent symptom is vaginal bleeding after a pregnancy, abortion, or hydatid mole.[2] A pregnancy test will be positive even if there is no embryo/fetus.[3]

Treatment

Chemotherapy is the treatment of choice. In certain cases, a hysterectomy and radiation are necessary.[4]

Prognosis

At the time of diagnosis, more than 90% of patients already have lung metastases, though there are also less frequent metastases to the brain and liver. With chemotherapy, there is an 80% 5-year survival rate. Ultimately, death is related to liver and brain metastases.

References
  1. NIH. "Choriocarcinoma". Retrieved 10 August 2012.
  2. NIH. "Choriocarcinoma". Retrieved 10 August 2012.
  3. NIH. "Choriocarcinoma". Retrieved 10 August 2012.
  4. NIH. "Choriocarcinoma". Retrieved 10 August 2012.


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