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Choriocarcinoma

Definition

Choriocarcinoma is a quick-growing form of cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus.

Choriocarcinoma is a type of gestational trophoblastic disease.

Alternative Names

Chorioblastoma; Trophoblastic tumor; Chorioepithelioma; Gestational trophoblastic neoplasia

Causes, incidence, and risk factors

Choriocarcinoma is an uncommon, but very often curable cancer that occurs during pregnancy. A baby may or may not develop in these types of pregnancy.

The cancer may occur after a normal pregnancy. However, it most often occurs with a complete hydatidiform mole . The abnormal tissue from the mole can continue to grow even after it is removed, and can turn into cancer. About half of all women with a choriocarcinoma had a hydatidiform mole, or molar pregnancy.

Choriocarcinomas may also occur after an early pregnancy that doesn't continue (miscarriage), ectopic pregnancy , or genital tumor .

Symptoms

A possible symptom is vaginal bleeding in a woman who recently had a hydatidiform mole or pregnancy.

Other symptoms may include:

  • Irregular vaginal bleeding
  • Pain

Signs and tests

A pregnancy test will be positive even if you are not pregnant. Pregnancy hormone (HCG) levels will be high.

A pelvic exam may show uterine swelling or a tumor.

Blood tests that may be done include:

Imaging tests that may be done include:

  • CT scan
  • MRI

You should be carefully monitored after a hydatidiform mole or at the end of a pregnancy. Getting diagnosed with choriocarcinoma early can improve the outcome.

Treatment

After you are diagnosed, a careful history and exam will be done to make sure the cancer has not spread to other organs. Chemotherapy is the main type of treatment.

A hysterectomy and radiation therapy are rarely needed.

Support Groups

For additional information, see cancer resources .

Expectations (prognosis)

Most women whose cancer has not spread can be cured and will still be able to have children. A choriocarcinoma may come back within a few months to 3 years after treatment.

The condition is harder to cure if the cancer has spread and one or more of the following happens:

  • Disease spreads to the liver or brain
  • Pregnancy hormone (HCG) level is greater than 40,000 mIU/mL when treatment begins
  • Cancer returns after having chemotherapy
  • Symptoms or pregnancy occurred for more than 4 months before treatment began
  • Choriocarcinoma occurred after a pregnancy that resulted in the birth of a child

Many women (about 70%) who have a poor outlook at first go into remission (a disease-free state).

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms within 1 year after a hydatidiform mole or pregnancy.

References

Goldstein DP, Berkowitz RS. Gestational trophoblastic disease. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. . 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 94.

McGee J, Covens A. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 35.

Braunstein GD. Endocrine changes in pregnancy. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. , 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 21.

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    Encyclopedia content is provided as information only and not intended to replace the advice and instruction from your personal physician.