Choriocarcinoma

Definition - What does Choriocarcinoma mean?

Gestational choriocarcinoma is a rapidly growing cancer that occurs during pregnancy and originates in the tissue that would normally develop into a placenta. It is the most aggressive form of gestational trophoblastic disease (GTD) - this tumor vastly invades the body tissues and disseminate to distant organs, primarily the lungs causing widespread destruction in the body. It most commonly develops after a complete hydatidiform mole (HM); nonetheless, a choriocarcinoma can occur after a normal conception. It is not a tumor of the uterus, which is secondarily involved.

FertilitySmarts explains Choriocarcinoma

Choriocarcinomas form in the uterus after fertilization of an egg by a sperm. Around 50% of choriocarcinomas occur after a molar pregnancy, 30% develop following an ectopic pregnancy or a miscarriage, and 20% are encountered following a normal pregnancy. Generally, the trophoblastic disease that occurs after a normal pregnancy could either be a choriocarcinoma or a placental site trophoblastic tumor but not a benign or an invasive mole.

A choriocarcinoma may be asymptomatic or it can present with symptoms resulting from its spread to the lungs (coughing up blood), brain (impaired conscious level or bleeding), or the bowels. This tumor might also manifest as heavy per vaginal bleeding after delivery.

Choriocarcinoma can also occur in infants, where it is termed as an Infantile choriocarcinoma. The tumor can cross the placenta and affect the baby.

Similar to other GTDs, choriocarcinoma also secretes abnormally high amounts of human chorionic gonadotropin (hCG). In addition to an ultrasound scan of the pelvis, a chest-Xray and a CT scan are essential to detect metastasis to lungs. An MRI scan is performed if brain involvement is suspected. Combination chemotherapy is effective for this aggressive form of GTD. Resistant lesions confined to the uterus warrant removal of the uterus that impairs fertility. However, despite being an aggressive cancer, choriocarcinoma is curable with treatment; thus, early diagnosis and intervention are crucial.

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