Choriocarcinoma
Choriocarcinoma is an aggressive cancer of the placenta. It is a quick growing form of cancer that occurs in a woman’s uterus after a pregnancy, miscarriage, or abortion. In approximately 50% of cases of choriocarcinoma, the woman had a hydatidiform mole (molar pregnancy). A minority of cases arise in the testis or the ovaries. In the United States, choriocarcinoma occurs in 1 out of 40,000 pregnancies. The disease is listed as a “rare disease” by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that choriocarcinoma affects less than 200,000 people in the US population.Choriocarcinomas are one of the most dangerous germ cell cancers because they usually grow quickly and spread widely. Choriocarcinomas disseminate rapidly through the hematogenous route; the lungs are most frequently affected.
The symptoms of a choriocarcinoma vary, the most common symptom being vaginal bleeding in a woman with a recent history of hydatidiform mole, abortion, or pregnancy. From the blood tests, highly significant is a persistently high HCG (pregnancy hormone) level (positive pregnancy test).
Chemotherapy is the treatment of choice. Choriocarcinoma is very sensitive to chemotherapy. The cure rate, even for metastatic choriocarcinoma, is around 90-95%. Virtually everyone without metastases can be cured. A hysterectomy is rarely required, but it can be offered to patients over 40 years of age. It may be required for those with severe infection and uncontrolled bleeding.
Choriocarcinomas in other sites have a poorer prognosis. These tumors tend to spread quickly and don’t always respond well to chemotherapy. Although treatment can be effective, the outcome usually depends on how widely the cancer is dispersed.
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