Choriocarcinoma

Alternative names

Chorioblastoma; Gestational trophoblastic disease; Trophoblastic tumor; Chorioepithelioma; Invasive/malignant mole; Gestational trophoblastic neoplasia

Definition

Gestational trophoblastic disease, or choriocarcinoma, is an aggressive, malignant, often metastatic (spreading) cancer in the uterus that begins following a pregnancy, a miscarriage, or an abortion.

Choriocarciona is among the most sensitive cancers to chemotherapy. As such, even when choriocarcinoma is metastatic, the cure rate is between 90 - 95%.

Causes, incidence, and risk factors

Hydatidiform mole is a condition which develops when a pregnancy has many complications. Conception takes place, but placental tissue grows very fast, rather than supporting the growth of a fetus.

The result is a tumor, rather than a baby. This is known as a molar pregnancy. There are only about 3,000 molar preganancies per year in the United States.

Choriocarcinoma is a similar type of growth. In approximately one-half of cases of choriocarcinoma, the preceding factor is hydatidiform mole. However, only 5 - 10% of molar pregnancies are associated with later choriocarcinoma. Therefore, choriocarcinoma remains an uncommon, yet almost always curable, cancer that can be associated with pregnancy.

Nearly one-fourth of choriocarcinomas follow a term pregnancy from which a normal child has been delivered. The remainder follow an abortion (spontaneous, elective, or therapeutic), ectopic pregnancy, or genital tumor.

Symptoms

A possible symptom is continued vaginal bleeding in a woman with a recent history of hydatidiform mole, abortion, or term pregnancy.

Additional symptoms that may be associated with this disease include:

• Irregular vaginal bleeding
  
• Theca lutein cysts on the ovaries
  
• Uneven enlargement of the uterus
  
• Persistently elevated HCG (pregnancy hormone) levels
  
• Pain
  
• Symptoms related to the disease spreading to other organs such as lungs, liver, and brain
  

Signs and tests
A pelvic examination may reveal continued uterine enlargement or a tumor. These conditions may be felt within the genito-urinary tract.

Tests include:

• Quantitative serum HCG (blood test to confirm pregnancy)
  
• CT scan to detect potential metastatic tumor in any organ