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    Choriocarcinoma

    Chorioblastoma; Trophoblastic tumor; Chorioepithelioma; Gestational trophoblastic neoplasia

    Choriocarcinoma is a quick-growing form of cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus.

    Choriocarcinoma is a type of gestational trophoblastic disease.

    Causes

    Choriocarcinoma is an uncommon, but very often curable cancer that occurs during pregnancy. A baby may or may not develop in these types of pregnancy.

    The cancer mayoccur after a normal pregnancy. However, it most oftenoccurs with a complete hydatidiform mole. The abnormal tissue from the mole can continue to grow even after it is removed, and can turn into cancer. About half of all women with a choriocarcinoma had a hydatidiform mole, or molar pregnancy.

    Choriocarcinomas may also occur after an early pregnancy that doesn't continue (miscarriage), ectopic pregnancy, or genital tumor.

    Symptoms

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

    Other symptoms may include:

    • Irregular vaginal bleeding
    • Pain

    Exams and Tests

    A pregnancy test will be positive evenif you are not pregnant. Pregnancy hormone (HCG) levels will behigh.

    A pelvic exam may show uterine swelling or a tumor.

    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

    You should be carefully monitored after a hydatidiform mole or at the end of a pregnancy. Getting diagnosed with choriocarcinoma early can improve the outcome.

    Treatment

    After you are diagnosed, a careful history andexam will bedone to make sure the cancer has not spread to other organs. Chemotherapy is the main type of treatment.

    A hysterectomy and radiation therapy are rarely needed.

    Support Groups

    For additional information, see cancer resources.

    Outlook (Prognosis)

    Most women whose cancer has not spread can be cured and will still be able to have children. A choriocarcinoma may come back within a few months to 3 years after treatment.

    The condition is harder to cure if the cancer has spread and one or more of the following happens:

    • Disease spreads to the liver or brain
    • Pregnancy hormone (HCG) level is greater than 40,000 mIU/mL when treatment begins
    • Cancer returns after having chemotherapy
    • Symptoms or pregnancy occurred for more than 4 months before treatment began
    • Choriocarcinoma occurred after a pregnancy that resulted in the birth of a child

    Many women (about 70%) who have a poor outlook at first go into remission (a disease-free state).

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if you develop symptoms within 1 year after a hydatidiform mole or pregnancy.

    References

    Goldstein DP, Berkowitz RS. Gestational trophoblastic disease. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG, eds. Abeloff’s Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 94.

    McGee J, Covens A. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 35.

    Braunstein GD. Endocrine changes in pregnancy. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology, 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 21.

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          Tests for Choriocarcinoma

            Review Date: 5/31/2012

            Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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