Definition of Choriocarcinoma:

Choriocarcinoma is 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.

See also:

• Gestational trophoblastic disease
• Hydatiform mole

Causes, incidence, and risk factors:

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

The cancer may develop after a normal pregnancy, however, it is most often associated 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 abortion, ectopic pregnancy, or genital tumor.

Symptoms:

A possible symptom is continued vaginal bleeding in a woman with a recent history of hydatidiform mole, abortion, or pregnancy.

Additional symptoms may include:

• Irregular vaginal bleeding
• Ovarian cysts
• Uneven swelling of the uterus
• Pain

Signs and tests:

A pregnancy test will be positive even when you are not pregnant. Pregnancy hormone (HCG) levels will be presistently high.

A pelvic examination may reveal continued 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

Treatment:

After an initial diagnosis, a careful history and examination are done 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.

Expectations (prognosis):

Most women whose cancer has not spread can be cured and will maintain reproductive function.

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

• Disease has spread to the liver or brain
• Pregnancy hormone (HCG) level is greater than 40,000 mIU/mL at the time treatment begins
• Having received chemotherapy in the past
• 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 initially have a poor outlook go into remission (a disease-free state).

Complications:

A choriocarcinoma may come back after treatment, usually within several months but possibly as late as 3 years. Complications associated with chemotherapy can also occur.

Calling your health care provider:

Call for an appointment with your health care provider if symptoms arise within 1 year after hydatidiform mole, abortion (including miscarriage), or term pregnancy.

Prevention:

Careful monitoring after the removal of hydatidiform mole or termination of pregnancy can lead to early diagnosis of a choriocarcinoma, which improves outcome.