Choriocarcinoma

Choriocarcinoma is a rare and aggressive type of cancer that primarily arises from trophoblastic cells, which are involved in the development of the placenta during pregnancy. It can occur after normal pregnancy, miscarriage, or molar pregnancy (where an abnormal growth of tissue develops instead of a viable fetus).

Key Points:

Types:

  1. Gestational Choriocarcinoma: Most common form, arising from placental tissue following pregnancy.
  2. Non-Gestational Choriocarcinoma: Rare and arises from germ cells in the ovaries or testicles.

Risk Factors:

  • Molar Pregnancy: Women who have had a complete or partial molar pregnancy are at higher risk.
  • Age: More common in younger women, particularly those under 20 and over 35.
  • Previous Gestational Trophoblastic Disease: History increases risk for future pregnancies.

Symptoms:

Symptoms can vary but may include:

  • Abnormal Vaginal Bleeding: Particularly following a recent pregnancy.
  • Enlarged Uterus: Due to the rapid growth of abnormal tissue.
  • Pelvic Pain: Discomfort or pain in the pelvic region.
  • Shortness of Breath or Cough: If the cancer spreads to the lungs.

Diagnosis:

  • Blood Tests: Elevated levels of human chorionic gonadotropin (hCG) can indicate choriocarcinoma.
  • Ultrasound: Used to visualize the uterus and detect abnormal growths.
  • Biopsy: Tissue sampling may be conducted to confirm diagnosis.
  • Imaging Tests: CT scans or MRIs can help assess if cancer has spread.

Treatment:

  1. Chemotherapy: The primary treatment, often very effective. Multi-agent chemotherapy regimens are commonly used.
  2. Surgery: May be needed to remove any remaining tumor tissue, especially if it is localized.
  3. Monitoring: Regular follow-up blood tests to monitor hCG levels after treatment.

Prognosis:

The prognosis for choriocarcinoma is generally good, especially if treated early. The response to chemotherapy is often very positive, with high cure rates for gestational choriocarcinoma.

Prevention:

While specific prevention methods are not established, early detection and monitoring of hCG levels after pregnancies, particularly following a molar pregnancy, are important for managing risk.