Chorioncarcinoma

Question 1

Definition

Answer 1

• Highly aggressive, malignant tumor consisting of trophoblastic tissue
• Exhibits histological signs of malignancy and a tendency to metastasize early

Question 2

Cause

Answer 2

Choriocarcinoma only develops after fertilization and implantation of the egg. Most cases of choriocarcinoma are preceded by a hydatidiform mole:
50% hydatidiform mole
25% miscarriages or ectopic pregnancy 🧨
25% normal pregnancy 👓

Question 3

Clinica

Answer 3

• Postpartum vaginal bleeding and inadequate uterine regression after delivery!
• Theca lutein cysts
• Additional symptoms depend on the site of metastasis (e.g., seizures from metastases in the brain; dyspnea or hemoptysis from metastases in the lungs)

Question 4

Diagnosi

Answer 4

1.Laboratory tests: very high β-HCG (initial test of choice)
2.Pelvic ultrasound: mass of varying appearance (suggestive of hemorrhage and necrosis); hypervascular on color Doppler
3.Uterine dilation and curettage (D&C)
Histopathologic examination shows cytotrophoblasts and syncytiotrophoblasts without chorionic villi👓
Both diagnostic and therapeutic (but only limited diagnostic value)

Staging
If malignancy is suspected
Chest x-ray: multiple nodules in lung metastasis
”Cannon ball” metastases

Question 5

Treatment

Cure rate of 95–100%;

Answer 5

1. Treatment of choice: chemotherapy
2. Surgical treatment (e.g., hysterectomy): may be indicated to stop bleeding from cancerous lesions or to excise distant metastases
3. Monitor β-HCG levels for at least 12 months.