Choriocarcinoma

What is choriocarcinoma?

Choriocarcinoma is a type of cancer that spreads rapidly and can develop in a woman’s uterus (womb). The tissue that would normally develop into the placenta is where the abnormal cells are first seen. This is the organ that develops during pregnancy in order to provide nutrition to the developing baby.

Choriocarcinoma is a a form of gestational trophoblastic disease.

Causes

Choriocarcinoma is a form of cancer that is extremely uncommon and manifests itself as an abnormal pregnancy. In this type of pregnancy, the development of a child is not guaranteed to take place.

It is also possible for the cancer to develop after a healthy pregnancy. However, it most frequently takes place in conjunction with a full-blown hydatidiform mole. In the early stages of pregnancy, a growth known as an amniotic sac develops on the interior of the womb. Even if an attempt is made to remove the mole, the abnormal tissue that originated from it may continue to grow and eventually develop into cancer. A hydatidiform mole, also known as a molar pregnancy, was present in approximately one half of all women who were diagnosed with choriocarcinoma.

It is also possible for choriocarcinomas to develop after an early pregnancy that does not progress (miscarriage). They are also possible following the development of a genital tumour or an ectopic pregnancy.

Symptoms

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

Other symptoms may include:

Irregular vaginal bleeding
Pain, which may be associated with the bleeding, or due to enlargement of the ovaries that often occurs with a choriocarcinoma

Diagnosis

A pregnancy test will be positive, even if you are not pregnant. The pregnancy hormone (HCG) level will be high.

A pelvic exam may find an enlarged uterus and ovaries.

Blood tests that may be done include:

Quantitative serum HCG
Complete blood count
Kidney function tests
Liver function tests

Imaging tests that may be done include:

CT scan
MRI
Pelvic ultrasound
Chest x-ray

You should be carefully monitored after a hydatidiform mole or at the end of a pregnancy. Early diagnosis of choriocarcinoma 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. Hysterectomy to remove the womb and radiation treatment are rarely needed.