Choriocarcinoma is a malignant and aggressive cancer of the placenta. It is characterized by early hematogenous spread to the lungs.

Etiology/Epidemiology

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It is preceded by

• hydatidiform mole (50% of cases)
• abortion of ectopic pregnancy (20% of cases)
• normal term pregnancy (20-30% of cases)

Symptoms/Signs/Labs

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• increased β-hCG levels
• vaginal bleeding

Pathology

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On light microscopy, there is malignant trophoblastic proliferation without hydropic villi.

Treatment

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Choriocarcinoma is one of the tumors that is most sensitive to chemotherapy. The cure rate, even for metastatic choriocarcinoma, is around 90-95%. Virtually everyone without metastases can be cured. Chemotherapy regimen include EMACO (etoposide, methotrexate, actinomycin D, cyclosphosphamide and oncovin).

Hysterectomy (surgical removal of the uterus) can also be offered to patients > 40 years of age or those desiring sterilization. It may be required for those with severe infection and uncontrolled bleeding.

Gynecology | Oncology