What is Choriocarcinoma?

D. Jeffress

Choriocarcinoma is a type of malignant tumor that arises in the reproductive tract. It is almost exclusively found in the placenta of pregnant women, though in rare instances choriocarcinoma can affect a post-menopausal woman's uterus or a male's testicles. Choriocarcinomas are considered very aggressive, and the cancer can quickly spread to the lungs, brain, liver, and other organs. In most cases, the cancer can be completely eradicated with successive chemotherapy treatments. Surgery to remove part or all of the uterus may be necessary if a tumor causes extensive tissue damage.

Choriocarcinoma may be completely eradicated when treated with chemotherapy.
Choriocarcinoma may be completely eradicated when treated with chemotherapy.

Most choriocarcinomas begin when large, precancerous masses called hydatidiform moles, which sometimes grow in uterine tissue at the start of pregnancies. A mole is essentially an excess of placental tissue, and even though a mole may impede fetal development, it is normally benign and poses no real threat to a woman's health. A choriocarcinoma forms when a hydatidiform mole turns cancerous and cells begin to proliferate and spread throughout the placenta. For reasons that are not well understood by doctors, some women experience tumors after spontaneous abortions or ectopic pregnancies. Testicular choriocarcinomas are related to undescended testes and genetic factors that predispose some men to cancer.

A woman may experience fatigue and weakness if choriocarcinoma has started to spread.
A woman may experience fatigue and weakness if choriocarcinoma has started to spread.

Signs that a woman may have a hydatidiform mole or choriocarcinoma include heavy vaginal bleeding and localized swelling. If the cancer has already started to spread, a woman may experience abdominal pain and feelings of fatigue and weakness. Cancer that reaches the liver and kidneys can cause jaundice, and lung complications may result in respiratory problems and nausea. A woman who experiences any abnormal symptoms during or after pregnancy should visit an obstetrician to receive a thorough evaluation.

A hysterctomy may be performed laparoscopically, allowing for faster recovery than a traditional open procedure.
A hysterctomy may be performed laparoscopically, allowing for faster recovery than a traditional open procedure.

A doctor can usually diagnose choriocarcinoma by examining the uterus and looking for cysts, lesions, and moles. He or she can collect a small tissue sample for laboratory analysis and conduct diagnostic imaging tests to look for cancer in other parts of the body. The obstetrician also collects blood samples to check for the presence of autoimmune disorders, viruses, or other abnormalities that may be contributing to symptoms.

Abdominal pain during pregnancy may be a sign of choriocarcinoma.
Abdominal pain during pregnancy may be a sign of choriocarcinoma.

After making a diagnosis, an obstetrician usually arranges for chemotherapy sessions. Most choriocarcinoma tumors can be ablated with chemotherapy, and women generally have very good prognoses following a few months of treatment. If a tumor is unresponsive to chemotherapy and continues to grow, the patient may need to undergo a surgical procedure called a partial or total hysterectomy. A surgeon can remove the affected section of uterine tissue to prevent the spread of cancer. With immediate treatment and frequent checkups, most people are able to fully recover from choriocarcinomas.

There are several types of diagnostic tests that a gynecologist can use to assess a possible choriocarcinoma.
There are several types of diagnostic tests that a gynecologist can use to assess a possible choriocarcinoma.
Diagnostic imaging tests look for cancer in the reproductive tract that may spread to the lungs or other areas of the body.
Diagnostic imaging tests look for cancer in the reproductive tract that may spread to the lungs or other areas of the body.
Choriocarcinoma may quickly spread to the liver.
Choriocarcinoma may quickly spread to the liver.

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