Nick Raine-Fenning
Course Director
Joined: 27 May 2006
Posts: 1862
Location: Nottingham
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 Posted: Sat Oct 28, 2006 10:47 am Post subject: Choriocarcinoma |
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Everything you ever wanted to know about CHORIOCARCINOMA in one minute!
Derived from intermediate trophoblastic cells 2ry to a prior pregnancy (normal or abnormal)
1 per 40 moles (usually complete), 1 per 150,000 normal pregnancies vs 1 per 2,500 in Nigeria
Risk factors: blood type A women and blood type A men (RR: 10.4:1)
50% prior moles, 25% prior abortions, 22% normal pregnancies, 3% ectopics or teratomas
Metastases to lungs, vagina, brain, liver, kidney, bowel; may resemble clear cell carcinoma
Serum hCG ~ 18,000, causes endocervical glandular hyperplasia, decidual reaction, Arias-Stella, bilateral enlargement of ovaries by theca-lutein cysts, breast epithelial ductal hyperplasia
Poor prognosis: age > 39, term pregnancy, long interval to diagnosis, high hCG, blood groups B or AB, large tumor, metastases to brain, GI, liver, >8 metastases, prior multiagent chemotherapy
Better prognosis if intense inflammatory infiltrate at interface between tumor and stroma
Surgery occasionally needed for hemorrhage
Monitor via serum hCG and chest Xrays
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